[Availability of Local Therapy to Castration-Resistant Prostate Cancer for M0 Patients with Initial Prostate Specific Antigen 100 ng/ml or Higher]

Prostate cancer patients with initial PSA 100 ng/ml or greater who received transrectal ultrasoundguided prostate biopsy and were staged as M0 by imaging studies from 2011 to 2014 in seven hospitals, were enrolled in the study.

Castration-resistant prostate cancer (CRPC)-free survival was compared between the two treatment groups : androgen deprivation therapy (ADT) alone and ADT plus local therapy. Of 142 prostate cancer patients with initial PSA 100 ng/ml or greater, 49 (34.5%) had no metastases and final analysis was performed on 46 patients. Thirty one M0 patients received ADT alone, and 15 received ADT plus local therapy. During follow-up (median 31 months, range 1-56 months) 13 patients (42%) in the ADT alone group progressed to CRPC. One- and two-year CRPC-free survival rates were 72.5 and 53%, respectively. No patients with ADT plus local therapy developed CRPC, and time to CRPC was prolonged significantly (p=0.002). On multivariate analysis for the group with ADT alone, PSA nadir of more than 0. 2 ng/ml and cN1 were independent predictors for progression to CRPC (p=0.009, 0.031). About one third of prostate cancer patients with initial PSA 100 ng/ml or greater had clinically no metastases. Local therapy to prostate combined with ADT may prolong time to CRPC compared with ADT alone. A subset of men with a PSA nadir of more than 0.2 ng/ml after ADT and cN1 could benefit from local therapy.

Hinyokika kiyo. Acta urologica Japonica. 2017 Dec [Epub]

Akito Kuromoto, Takaki Tanaka, Juntaro Koyama, Takuro Goto, Shingo Kimura, Yuki Katsumata, Shingo Myoen, Michinobu Ozawa, Kento Morozumi, Masahiko Sato, Senji Hoshi, Kenji Numahata, Yoichi Arai

The Department of Urology, Yamagata Prefectural Central Hospital., The Department of Urology, Miyagi Cancer Center., The Department of Urology, Shirakawa Kousei General Hospital., The Department of Urology, Tohoku Rosai Hospital., The Department of Urology, Iwate Prefectural Iwai Hospital., The Department of Urology, Iwaki Kyouritsu Hospital., The Department of Urology, Hachinohe City Hospital., The Department of Urology, Tohoku University School of Medicine.

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