[Evaluation of immediate androgen deprivation adjuvant therapy in patients with lymph node positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy].
OBJECTIVE
We assessed the outcome after radical prostatectomy and pelvic lymphadenectomy for lymph node positive prostate cancer retrospectively. Furthermore, we compared the efficacy of immediate androgen deprivation adjuvant therapy in node positive patients who have undergone radical prostatectomy.


METHODS
We investigated 62 patients who have undergone radical prostatectomy and pelvic lymphadenectomy and have been found to have lymph node positive prostate cancer at our facility between January 1992 and January 2008. We researched the clinical stages, the pathological stages and Gleason scores for pathological pN1 + prostate cancer, retrospectively. The serum PSA levels were followed up every 6 months, and we considered that biochemical progression was PSA >0.4 ng/ml. We classified the groups treated with or without immediate androgen deprivation adjuvant therapy, the biochemical progression free survival and cause specific survival were analyzed by the Kaplan-Meier method, and the statistical significance was determined by the log rank test.


RESULTS
The rate of lymph node positive patients who have undergone radical prostatectomy was 7.1%. The rate of 8 or greater in Gleason score of all the lymph node positive patients was 68.3%. The 5-year prostate cancer specific survival and 5-year biochemical progression free survival rates were 90.3 and 67.4% of all the patients. The biochemical progression free survival rate of the group of patients who have received immediate androgen deprivation therapy after radical prostatectomy was significantly higher than that of the group of patients who have not received immediately androgen deprivation therapy.


CONCLUSIONS
It may be suggested that early androgen deprivation adjuvant therapy benefits patients with nodal metastases who have undergone radical prostatectomy and lymphadenectomy, compared with those who received deferred treatment, although in a retrospective nonrandomized study.
Miyamae
Koichi
K
Department of Urology, Kumamoto Chuo Hospital.
Kitani
Kosuke
K
Miyamoto
Kenji
K
Hamada
Shinsuke
S
Kawano
Takashi
T
Maehara
Akihito
A
Otsuka
Yoshiaki
Y
Otsuka
Tomohiro
T
Hamada
Yasuyuki
Y
D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone