Premium
Primary androgen deprivation (AD) followed by active surveillance (AS) for newly diagnosed prostate cancer (PC): A retrospective study
Author(s) -
Scholz Mark C.,
Groom Meg K.,
Kaddis Andrew J.,
Strum Stephen B.,
Jennrich Robert I.,
Bahn Duke K.,
Chang Patricia J.,
Becker Lauren K.,
Lam Richard Y.
Publication year - 2013
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.22543
Subject(s) - medicine , prostate cancer , prostate , retrospective cohort study , androgen , androgen deprivation therapy , oncology , cancer , gynecology , hormone
Abstract BACKGROUND Active surveillance (AS) is only recommended for Low‐Risk prostate cancer (PC) with <34% biopsies positive. Studies describing the long‐term outcome of men treated with androgen deprivation (AD) followed by AS are sparse. MATERIALS AND METHODS One hundred two men were treated with 12 months of AD in a medical oncology clinic specializing in PC between 1998 and 2007 and were followed for a median of 7.25 years. The biopsy complete response rate after AD and the incidence of disease progression while on subsequent AS was assessed. Baseline age, D'Amico risk category, PSA velocity, percentage core biopsies, and prostate volume were evaluated as potential predictors of disease progression. RESULTS D'Amico risk category for the 102 men: Low : n = 22, Intermediate : n = 30, and High : n = 50. Medians: Age 67.3, PSA 7.8, Gleason 3 + 4, >50% core biopsies positive, stage T1c. Seventy men had a clear biopsy and 31 of these had disease progression leading to additional treatment after a median of 52 months. D'Amico risk category of the 57 men with a positive biopsy after AD or disease progression on AS was: Low : n = 4 (18%), Intermediate : n = 16 (53%), and High : n = 37 (74%). No PC deaths occurred. Three men had clinical progression. In stepwise logistic regression analysis only higher D'Amico risk category and lower prostate volume predicted disease progression. CONCLUSIONS Despite a high prevalence of ≥50% core biopsies positive at baseline, AD induces durable remissions in most men with Low‐Risk and about half with Intermediate‐Risk PC. Prostate 73: 83–88, 2013. © 2012 Wiley Periodicals, Inc.