title: Cessation of Primary Androgen Deprivation Therapy for Men With Localized Prostate Cancer.
abstract: BACKGROUND
  Substantial numbers of men with localized prostate cancer undergo long-term primary androgen deprivation therapy (ADT). Whether long-term ADT is required for patients with localized prostate cancer, especially elderly men, remains unknown. In the present study, we explored the possibility of ADT cessation after a favorable response to primary ADT in patients with localized prostate cancer.
  
  
  METHODS
  We retrospectively reviewed men with localized prostate cancer who had achieved a good initial response to primary ADT and stopped it thereafter. Prostate-specific antigen (PSA) recurrence was defined as 2 consecutive increases > 4 ng/mL. A total of 34 patients (age, 62-89 years) were followed up for > 24 months after ADT cessation.
  
  
  RESULTS
  The ADT duration and follow-up period after ADT cessation was 10 to 162 months (median, 33.5 months) and 24 to 95 months (median, 37 months), respectively. PSA recurrence was observed in 10 of 34 patients (29.4%), and the 5-year PSA progression-free rate was 66.2%. PSA recurrence was observed in 100% (6 of 6) and 14.3% (4 of 28) of men who had received ADT for < 16 months and > 16 months, respectively. ADT was reinstated in 5 patients after PSA recurrence; and their PSA levels declined rapidly, and no clinical progression was observed. The 5-year overall and disease-specific survival rate was 65.1% and 100%, respectively.
  
  
  CONCLUSIONS
  ADT can be stopped for men with localized prostate cancer, especially elderly men, after a favorable response to primary ADT.
authors.affiliation: Department of Urology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan. Electronic address: n-fuji@med.uoeh-u.ac.jp.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: Department of Public Health, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Urology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan.
authors.forename: Ikko
authors.initials: I
authors.lastname: Tomisaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007610:Kallikreins / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D013739:Testosterone / Q000097:blood; D028761:Withholding Treatment
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D013739:Testosterone; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Androgen deprivation; Cessation; Localized cancer; PSA recurrence; Prostate