Potential of combined androgen blockade (CAB) has not been explored extensively in Chinese males with prostate cancer (PCa). Therefore, this study evaluated the 2-year prostate-specific antigen (PSA) recurrence rate and quality of life (QoL) in patients with high-risk localized and locally advanced PCa receiving adjuvant hormone therapy (HT) after radical prostatectomy (RP).
This prospective, multicenter, observational study conducted in 18 centers across China enrolled patients with high-risk factor (preoperative PSA>20 ng/mL or Gleason score >7) or locally advanced PCa. Different adjuvant HT were administered after RP according to investigator's decision in routine clinical practice. Relationship of baseline and postoperative characteristics was assessed with recurrence rate. PSA recurrence rate and Functional Assessment of Cancer Therapy-Prostate (FACT-P) QoL scores were recorded at 12 months and 24 months. Kaplan-Meier analysis was used to construct the PSA recurrence rate during follow-up.
A total of 189 patients (mean age: 66.9±6.5 years) were recruited, among which 112 (59.3%) patients showed serum PSA>20 ng/mL preoperatively. The highest postoperative pathological advancement noticed was from clinical T2 (cT2) to pathological T3 (pT3) (43.9%) stage. The majority of the patients (66.1%) received CAB as adjuvant HT, for a median duration of 20.0 months. The least recurrence (15.2%) was noticed in patients treated with CAB, followed by those treated with luteinizing hormone-releasing hormone agonist (LHRHa) (16.1%), and antiandrogen (19.0%), with non-significant difference noted among the groups. None of the baseline or postoperative characteristics was related with PSA recurrence in our study. The 24-month FACT-P QoL score of 119 patients treated for >12 months showed significant improvement above baseline compared with those treated for ≤12 months.
Adjuvant CAB therapy after RP showed reduction trend in 2-year PSA recurrence rate in high-risk Chinese patients with localized and locally advanced PCa, compared with adjuvant anti-androgens (AA) or LHRHa therapy. Further long-term therapy (>12 months) significantly improved QoL compared to short-term HT therapy, suggesting the beneficial effect of long-term CAB therapy in improving QoL.
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu. 2019 Jun [Epub]
Dingwei Ye, Wei Zhang, Lulin Ma, Chuanjun Du, Liping Xie, Yiran Huang, Qiang Wei, Zhangqun Ye, Yanqun Na
Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China., Department of Urology, Jiangsu Province Hospital, Nanjing 210029, China., Department of Urology, Peking University Third Hospital, Beijing 100191, China., Department of Urology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China., Department of Urology, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China., Department of Urology, Renji Hospital Shanghai Jiaotong University School of Medicine, Shanghai 200127, China., Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China., Department of Urology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China., Department of Urology, Peking University Shougang Hospital, Beijing 100144, China.