Impact of adjuvant androgen deprivation therapy after radical prostatectomy on the survival of patients with pathological T3b prostate cancer

Sameer A. Siddiqui, Stephen A. Boorjian, Michael L. Blute, Laureano J. Rangel, Eric J. Bergstralh, Robert Jeffrey Karnes, Igor Frank

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE To determine the impact of adjuvant androgen deprivation therapy (ADT) on survival in patients with seminal vesicle invasion (pT3b) at radical prostatectomy. PATIENTS AND METHODS We reviewed 12 115 patients who underwent radical prostatectomy between 1987 and 2002 to identify patients with pT3bN0 prostate cancer who received adjuvant ADT (n= 191). These patients were matched by clinical and pathological variables to a group of patients with pT3b prostate cancer who did not receive adjuvant ADT. Median postoperative follow-up was 10 years. Clinical endpoints included biochemical progression-free survival (BPFS), local recurrence-free survival (LRFS), systemic progression-free survival (SPFS), cancer-specific survival (CSS) and overall survival. RESULTS Patients who underwent adjuvant ADT experienced improved 10-year BPFS (60% vs 16%, P < 0.001), LRFS (87% vs 76%, P= 0.002), SPFS (91% vs 78%, P= 0.004) and CSS (94% vs 87%, P= 0.037). Overall survival was not significantly different between groups (75% vs 69%, P= 0.12). Both luteinizing hormone-releasing hormone agonists (hazard ratio, 0.26; 95% CI, 0.15-0.46; P < 0.001) and bilateral orchiectomy (hazard ratio, 0.13; 95% CI, 0.06-0.31; P < 0.001) improved BPFS. When stratified by type of ADT (hormonal therapy vs orchiectomy), there was no difference in survival outcomes. CONCLUSIONS Adjuvant ADT improves local, and systemic control after radical prostatectomy for pT3b prostate cancer. There is no difference in survival between patients receiving medical hormonal therapy vs patients undergoing orchiectomy. Given the lack of improvement in overall survival, continued investigation is needed to identify the cohort of pT3b patients at highest risk for cancer progression and therefore most likely to benefit from a multimodal treatment approach.

Original languageEnglish (US)
Pages (from-to)383-388
Number of pages6
JournalBJU International
Volume107
Issue number3
DOIs
StatePublished - Feb 2011

Fingerprint

Prostatectomy
Androgens
Prostatic Neoplasms
Survival
Disease-Free Survival
Orchiectomy
Therapeutics
Recurrence
Combined Modality Therapy
Neoplasms
Seminal Vesicles
Gonadotropin-Releasing Hormone

Keywords

  • androgen deprivation therapy
  • hormones
  • prostate cancer
  • radical prostatectomy
  • survival

ASJC Scopus subject areas

  • Urology

Cite this

Impact of adjuvant androgen deprivation therapy after radical prostatectomy on the survival of patients with pathological T3b prostate cancer. / Siddiqui, Sameer A.; Boorjian, Stephen A.; Blute, Michael L.; Rangel, Laureano J.; Bergstralh, Eric J.; Karnes, Robert Jeffrey; Frank, Igor.

In: BJU International, Vol. 107, No. 3, 02.2011, p. 383-388.

Research output: Contribution to journalArticle

Siddiqui, Sameer A. ; Boorjian, Stephen A. ; Blute, Michael L. ; Rangel, Laureano J. ; Bergstralh, Eric J. ; Karnes, Robert Jeffrey ; Frank, Igor. / Impact of adjuvant androgen deprivation therapy after radical prostatectomy on the survival of patients with pathological T3b prostate cancer. In: BJU International. 2011 ; Vol. 107, No. 3. pp. 383-388.
@article{7d5a74635a4d4569917564b9477c567a,
title = "Impact of adjuvant androgen deprivation therapy after radical prostatectomy on the survival of patients with pathological T3b prostate cancer",
abstract = "OBJECTIVE To determine the impact of adjuvant androgen deprivation therapy (ADT) on survival in patients with seminal vesicle invasion (pT3b) at radical prostatectomy. PATIENTS AND METHODS We reviewed 12 115 patients who underwent radical prostatectomy between 1987 and 2002 to identify patients with pT3bN0 prostate cancer who received adjuvant ADT (n= 191). These patients were matched by clinical and pathological variables to a group of patients with pT3b prostate cancer who did not receive adjuvant ADT. Median postoperative follow-up was 10 years. Clinical endpoints included biochemical progression-free survival (BPFS), local recurrence-free survival (LRFS), systemic progression-free survival (SPFS), cancer-specific survival (CSS) and overall survival. RESULTS Patients who underwent adjuvant ADT experienced improved 10-year BPFS (60{\%} vs 16{\%}, P < 0.001), LRFS (87{\%} vs 76{\%}, P= 0.002), SPFS (91{\%} vs 78{\%}, P= 0.004) and CSS (94{\%} vs 87{\%}, P= 0.037). Overall survival was not significantly different between groups (75{\%} vs 69{\%}, P= 0.12). Both luteinizing hormone-releasing hormone agonists (hazard ratio, 0.26; 95{\%} CI, 0.15-0.46; P < 0.001) and bilateral orchiectomy (hazard ratio, 0.13; 95{\%} CI, 0.06-0.31; P < 0.001) improved BPFS. When stratified by type of ADT (hormonal therapy vs orchiectomy), there was no difference in survival outcomes. CONCLUSIONS Adjuvant ADT improves local, and systemic control after radical prostatectomy for pT3b prostate cancer. There is no difference in survival between patients receiving medical hormonal therapy vs patients undergoing orchiectomy. Given the lack of improvement in overall survival, continued investigation is needed to identify the cohort of pT3b patients at highest risk for cancer progression and therefore most likely to benefit from a multimodal treatment approach.",
keywords = "androgen deprivation therapy, hormones, prostate cancer, radical prostatectomy, survival",
author = "Siddiqui, {Sameer A.} and Boorjian, {Stephen A.} and Blute, {Michael L.} and Rangel, {Laureano J.} and Bergstralh, {Eric J.} and Karnes, {Robert Jeffrey} and Igor Frank",
year = "2011",
month = "2",
doi = "10.1111/j.1464-410X.2010.09565.x",
language = "English (US)",
volume = "107",
pages = "383--388",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Impact of adjuvant androgen deprivation therapy after radical prostatectomy on the survival of patients with pathological T3b prostate cancer

AU - Siddiqui, Sameer A.

AU - Boorjian, Stephen A.

AU - Blute, Michael L.

AU - Rangel, Laureano J.

AU - Bergstralh, Eric J.

AU - Karnes, Robert Jeffrey

AU - Frank, Igor

PY - 2011/2

Y1 - 2011/2

N2 - OBJECTIVE To determine the impact of adjuvant androgen deprivation therapy (ADT) on survival in patients with seminal vesicle invasion (pT3b) at radical prostatectomy. PATIENTS AND METHODS We reviewed 12 115 patients who underwent radical prostatectomy between 1987 and 2002 to identify patients with pT3bN0 prostate cancer who received adjuvant ADT (n= 191). These patients were matched by clinical and pathological variables to a group of patients with pT3b prostate cancer who did not receive adjuvant ADT. Median postoperative follow-up was 10 years. Clinical endpoints included biochemical progression-free survival (BPFS), local recurrence-free survival (LRFS), systemic progression-free survival (SPFS), cancer-specific survival (CSS) and overall survival. RESULTS Patients who underwent adjuvant ADT experienced improved 10-year BPFS (60% vs 16%, P < 0.001), LRFS (87% vs 76%, P= 0.002), SPFS (91% vs 78%, P= 0.004) and CSS (94% vs 87%, P= 0.037). Overall survival was not significantly different between groups (75% vs 69%, P= 0.12). Both luteinizing hormone-releasing hormone agonists (hazard ratio, 0.26; 95% CI, 0.15-0.46; P < 0.001) and bilateral orchiectomy (hazard ratio, 0.13; 95% CI, 0.06-0.31; P < 0.001) improved BPFS. When stratified by type of ADT (hormonal therapy vs orchiectomy), there was no difference in survival outcomes. CONCLUSIONS Adjuvant ADT improves local, and systemic control after radical prostatectomy for pT3b prostate cancer. There is no difference in survival between patients receiving medical hormonal therapy vs patients undergoing orchiectomy. Given the lack of improvement in overall survival, continued investigation is needed to identify the cohort of pT3b patients at highest risk for cancer progression and therefore most likely to benefit from a multimodal treatment approach.

AB - OBJECTIVE To determine the impact of adjuvant androgen deprivation therapy (ADT) on survival in patients with seminal vesicle invasion (pT3b) at radical prostatectomy. PATIENTS AND METHODS We reviewed 12 115 patients who underwent radical prostatectomy between 1987 and 2002 to identify patients with pT3bN0 prostate cancer who received adjuvant ADT (n= 191). These patients were matched by clinical and pathological variables to a group of patients with pT3b prostate cancer who did not receive adjuvant ADT. Median postoperative follow-up was 10 years. Clinical endpoints included biochemical progression-free survival (BPFS), local recurrence-free survival (LRFS), systemic progression-free survival (SPFS), cancer-specific survival (CSS) and overall survival. RESULTS Patients who underwent adjuvant ADT experienced improved 10-year BPFS (60% vs 16%, P < 0.001), LRFS (87% vs 76%, P= 0.002), SPFS (91% vs 78%, P= 0.004) and CSS (94% vs 87%, P= 0.037). Overall survival was not significantly different between groups (75% vs 69%, P= 0.12). Both luteinizing hormone-releasing hormone agonists (hazard ratio, 0.26; 95% CI, 0.15-0.46; P < 0.001) and bilateral orchiectomy (hazard ratio, 0.13; 95% CI, 0.06-0.31; P < 0.001) improved BPFS. When stratified by type of ADT (hormonal therapy vs orchiectomy), there was no difference in survival outcomes. CONCLUSIONS Adjuvant ADT improves local, and systemic control after radical prostatectomy for pT3b prostate cancer. There is no difference in survival between patients receiving medical hormonal therapy vs patients undergoing orchiectomy. Given the lack of improvement in overall survival, continued investigation is needed to identify the cohort of pT3b patients at highest risk for cancer progression and therefore most likely to benefit from a multimodal treatment approach.

KW - androgen deprivation therapy

KW - hormones

KW - prostate cancer

KW - radical prostatectomy

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=79251539583&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79251539583&partnerID=8YFLogxK

U2 - 10.1111/j.1464-410X.2010.09565.x

DO - 10.1111/j.1464-410X.2010.09565.x

M3 - Article

C2 - 21265985

AN - SCOPUS:79251539583

VL - 107

SP - 383

EP - 388

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 3

ER -