Korean J Urol.  2009 Nov;50(11):1073-1077.

Efficacy of Androgen Deprivation Therapy in Patients with Clinically Localized Prostate Cancer

• Kim TS
• Kang SH
• Rhew HY

Abstract

PURPOSE
The purpose of this study was to evaluate the characteristics of patients who received primary androgen deprivation therapy (PADT) for clinically localized prostate cancer and the clinical efficacy of this treatment.
MATERIALS AND METHODS
Between January 1998 and August 2007, patients who underwent PADT for clinically localized prostate adenocarcinoma were analyzed. The patients studied could not receive definitive therapy owing to old age or medical comorbidities. All patients' Gleason score, pretreatment prostate-specific antigen (PSA) value, time to PSA progression, and D'Amico's risk criteria were analyzed.
RESULTS
A total of 72 patients were analyzed. The patients' mean age was 75.29 years (range, 57-92 years) and their median pretreatment PSA was 13.52 ng/ml (range, 1.27-74.82 ng/ml). The median follow-up duration was 39 months (range, 18-115 months). Thirteen patients (18.57%) had PSA progression after reaching a PSA nadir. The mean time to PSA progression was 14 months (range, 7-55 months). Among these 13 patients, 2 patients had low-risk prostate cancer and 11 patients had high-risk prostate cancer by D'Amico's risk criteria. Three of the 13 patients are now receiving chemotherapy, 2 patients died from cancer progression, 3 patients died of a non-cancer cause, and 5 patients are now being conservatively managed. Of the total 72 patients, 70.83% of the patients are still receiving PADT. A total of 11 patients died; however, only 2 deaths were caused by prostate cancer.
CONCLUSIONS
In patients with localized prostate cancer who could not receive definitive therapy for several reasons, the cancer-caused death rate was very low, even in patients with PSA progression. PADT is an effective therapeutic option in patients with localized prostate cancer.

Keyword

Prostate; Androgens; Prostate-specific antigen

MeSH Terms

Adenocarcinoma
Androgens
Comorbidity
Follow-Up Studies
Humans
Neoplasm Grading
Prostate
Prostate-Specific Antigen
Prostatic Neoplasms
Androgens
Prostate-Specific Antigen

Figure

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  Fig. 1 Time to discontinuation of primary androgen deprivation therapy. Patients had stopped primary androgen deprivation therapy for several reasons such as prostate-specific antigen (PSA) progression, old age, poor performance, etc.

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  Fig. 2 Prostate-specific antigen (PSA) progression-free survival in patients who received primary androgen deprivation therapy.

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