The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer : Results of a Matched Multiinstitutional Analysis

الملخص EN

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.