title: Endocrine therapy with or without radical prostatectomy for T1b-T3N0M0 prostate cancer.
abstract: 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.
authors.affiliation: Department of Urology, University of Tokyo, Tokyo, Japan. homma-uro@umin.ac.jp
authors.forename: Yukio
authors.initials: Y
authors.lastname: Homma
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
authors.forename: Kiyoki
authors.initials: K
authors.lastname: Okada
authors.forename: Masao
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Michiyuki
authors.initials: M
authors.lastname: Usami
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hirao
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tsushima
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Aso
mesh_terms: D000367:Age Factors; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002715:Chlormadinone Acetate / Q000627:therapeutic use; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D002715:Chlormadinone Acetate; D017430:Prostate-Specific Antigen; D016729:Leuprolide