A retrospective comparison of androgen deprivation (AD) vs. no AD among low-risk and intermediate-risk prostate cancer patients treated with brachytherapy, external beam radiotherapy, or radical prostatectomy.
OBJECTIVE
To examine the value of androgen deprivation (AD) in the curative treatment of low- and intermediate-risk prostate cancer treated with the three major modalities: radical retropubic prostatectomy (RRP), external beam radiotherapy (EBRT), and permanent prostate implantation (PI).


METHODS
During 1996-2001, 1668 patients with low- and intermediate-risk prostate cancer were treated at The Cleveland Clinic Foundation. Only patients with a minimum of 2 years of prostate-specific antigen follow-up were included in the analysis, and biochemical relapse-free survival (bRFS) was used as the endpoint. Patients were grouped according to treatment modality and stratified according to the use of AD.


RESULTS
The overall 5-year bRFS rate was 87.8%. The 5-year bRFS rate for low-risk patients was 89% and for intermediate-risk patients was 79%. For low-risk patients, the 5-year bRFS rates by treatment modality (without AD vs. with AD, respectively) were PI: 90% vs. 93%; EBRT: 90% vs. 93%; and RRP: 89% vs. 84%. For intermediate-risk patients, the 5-year bRFS rates by treatment modality (without AD vs. with AD, respectively) were PI: 88% vs. 82%; EBRT: 81% vs. 84%; and RRP: 75% vs. 72%. None of the comparisons within risk groups or among modalities supports an increased efficacy with the use of AD.


CONCLUSIONS
Five-year bRFS rates in low-risk and intermediate-risk patients are not improved by the use of AD.
Ciezki
Jay P
JP
Department of Radiation Oncology, The Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. ciezkij@ccf.org
Klein
Eric A
EA
Angermeier
Kenneth
K
Ulchaker
James
J
Chehade
Nabil
N
Altman
Andrew
A
Mahadevan
Arul
A
Reddy
Chandana A
CA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate
D017430:Prostate-Specific Antigen