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Adv Urol. 2012;2012:612707. doi: 10.1155/2012/612707. Epub 2012 Jan 31.

The role of adjuvant hormonal treatment after surgery for localized high-risk prostate cancer: results of a matched multiinstitutional analysis.

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1
Department of Urology and Pediatric Urology, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany.

Abstract

INTRODUCTION:

To assess the role of adjuvant androgen deprivation therapy (ADT) in high-risk prostate cancer patients (PCa) after surgery.

MATERIALS AND METHODS:

The analysis case matched 172 high-risk PCa patients with positive section margins or non-organ confined disease and negative lymph nodes to receive adjuvant ADT (group 1, n = 86) or no adjuvant ADT (group 2, n = 86).

RESULTS:

Only 11.6% of the patients died, 2.3% PCa related. Estimated 5-10-year clinical progression-free survival was 96.9% (94.3%) for group 1 and 73.7% (67.0%) for group 2, respectively. Subgroup analysis identified men with T2/T3a tumors at low-risk and T3b margins positive disease at higher risk for progression.

CONCLUSION:

Patients with T2/T3a tumors are at low-risk for metastatic disease and cancer-related death and do not need adjuvant ADT. We identified men with T3b margin positive disease at highest risk for clinical progression. These patients benefit from immediate adjuvant ADT.

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