Evaluation of primary androgen deprivation therapy in prostate cancer patients using the J-CAPRA risk score.
OBJECTIVE
To determine the influence of maximal androgen blockade (MAB) and non-MAB hormonal therapy with an luteinizing hormone releasing hormone (LHRH) analog on overall survival of prostate cancer patients in the Japan Study Group of Prostate Cancer (J-CaP) registry according to risk, as assessed using the novel J-CAPRA risk instrument. To undertake a multivariate analysis combining J-CAPRA risk score, type of hormonal therapy and comorbidities, in order to assess their impact on overall survival.


METHODS
The J-CaP database includes men in Japan diagnosed with any stage of prostate cancer between 2001 and 2003 and treated with primary androgen deprivation therapy (PADT), as monotherapy or in combination. A total of 26,272 men were enrolled and of these 19,265 were treated with PADT. This analysis was undertaken using the latest data set (30 April, 2010) including a total of 15,727 patients who received PADT and had follow-up data for periods ranging from 0 to 9.2 years.


RESULTS
MAB for prostate cancer patients with intermediate- or high-risk disease has a significant benefit in terms of overall survival compared with LHRH analog monotherapy or surgical castration alone. Better results may be achieved in older (≥75 years) patients. Patient comorbidities are an important factor in determining overall survival, notably in older patients, and should be considered when selecting therapy.


CONCLUSIONS
Based on large-scale registry data, this report is the first to analyze the outcomes of MAB therapy in patients with prostate cancer at a wide range of disease stages. MAB therapy may provide significant survival benefits in intermediate- and high-risk patients.
Department of Strategic Investigation on Comprehensive Cancer Network Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.
Hideyuki
H
Akaza
Shiro
S
Hinotsu
Michiyuki
M
Usami
Osamu
O
Ogawa
Tadaichi
T
Kitamura
Kazuhiro
K
Suzuki
Taiji
T
Tsukamoto
Seiji
S
Naito
Mikio
M
Namiki
Yoshihiko
Y
Hirao
Masaru
M
Murai
Maximal androgen blockade; Overall survival; Primary androgen deprivation therapy; Prostate neoplasms; Risk scoring