title: Primary androgen deprivation (AD) followed by active surveillance (AS) for newly diagnosed prostate cancer (PC): A retrospective study.
abstract: BACKGROUND
  Active surveillance (AS) is only recommended for Low-Risk prostate cancer (PC) with <34% biopsies positive. Studies describing the long-term outcome of men treated with androgen deprivation (AD) followed by AS are sparse.
  
  
  METHODS
  One hundred two men were treated with 12 months of AD in a medical oncology clinic specializing in PC between 1998 and 2007 and were followed for a median of 7.25 years. The biopsy complete response rate after AD and the incidence of disease progression while on subsequent AS was assessed. Baseline age, D'Amico risk category, PSA velocity, percentage core biopsies, and prostate volume were evaluated as potential predictors of disease progression.
  
  
  RESULTS
  D'Amico risk category for the 102 men: Low: n = 22, Intermediate: n = 30, and High: n = 50. Medians: Age 67.3, PSA 7.8, Gleason 3 + 4, >50% core biopsies positive, stage T1c. Seventy men had a clear biopsy and 31 of these had disease progression leading to additional treatment after a median of 52 months. D'Amico risk category of the 57 men with a positive biopsy after AD or disease progression on AS was: Low: n = 4 (18%), Intermediate: n = 16 (53%), and High: n = 37 (74%). No PC deaths occurred. Three men had clinical progression. In stepwise logistic regression analysis only higher D'Amico risk category and lower prostate volume predicted disease progression.
  
  
  CONCLUSIONS
  Despite a high prevalence of ≥50% core biopsies positive at baseline, AD induces durable remissions in most men with Low-Risk and about half with Intermediate-Risk PC.
authors: Prostate Oncology Specialists, Prostate Institute of America, University of California at Los Angeles, Ashland Community Hospital, Marina del Rey, CA 90292, USA. mark@prostateoncology.com
authors: Mark C
authors: MC
authors: Scholz
authors: Meg K
authors: MK
authors: Groom
authors: Andrew J
authors: AJ
authors: Kaddis
authors: Stephen B
authors: SB
authors: Strum
authors: Robert I
authors: RI
authors: Jennrich
authors: Duke K
authors: DK
authors: Bahn
authors: Patricia J
authors: PJ
authors: Chang
authors: Lauren K
authors: LK
authors: Becker
authors: Richard Y
authors: RY
authors: Lam
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D062005:Biopsy, Large-Core Needle; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D057832:Watchful Waiting
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D017430:Prostate-Specific Antigen