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Endocrine therapy with or without radical prostatectomy for T1b‐T3N0M0 prostate cancer
Author(s) -
HOMMA YUKIO,
AKAZA HIDEYUKI,
OKADA KIYOKI,
YOKOYAMA MASAO,
USAMI MICHIYUKI,
HIRAO YOSHIHIKO,
TSUSHIMA TOMOYASU,
SAKAMOTO ATSUHIKO,
OHASHI YASUO,
ASO YOSHIO
Publication year - 2004
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2003.00781.x
Subject(s) - medicine , prostatectomy , prostate cancer , urology , survival rate , endocrine system , cancer , oncology , hormone
Background: We retrospectively compared the 5‐year survival rates of T1b‐T3N0M0 prostate cancer patients treated either by endocrine therapy plus radical prostatectomy or endocrine therapy alone. Methods: Clinical T1b‐T3N0M0 prostate cancer patients were enrolled at 104 institutions in Japan. They were assigned to study 1 ( n = 176), if they were indicated to prostatectomy, if not indicated, they were assigned to study 2 ( n = 151). The indication of prostatectomy was based on the clinical judgement of physicians and/or patients. Those assigned to study 1 underwent prostatectomy and adjuvant endocrine therapy with or without preoperative androgen deprivation. Those assigned to study 2 were treated with leuprorelin acetate with or without chlormadinone acetate. They were followed‐up every 3 months until death or for 5 years and over. Results: Those assigned to study 1 were younger (mean age 67.2 vs 75.7 years), less advanced in clinical stage, and had lower prostate specific antigen levels (mean 43.8 vs 103.6 ng/mL). Death for any reason was observed less frequently in study 1 ( n = 29, 16%) than study 2 ( n = 50, 33%), and the 5‐year overall survival rate was higher in study 1 (87 vs. 68%). However, prostate cancer deaths were comparatively seldom (9% in study 1 and 7% in study 2), resulting in the identical 5‐year cause specific survival rate in both study groups (91%). In both study groups the overall survival was almost equal to the natural survival of age‐matched men. Conclusions: Endocrine therapy offers a reasonable survival rate in T1b‐T3 prostate cancer patients within a 5‐year follow‐up. Observation will be extended to determine 10‐year outcomes.