AUA 2011 - Avoiding androgen deprivation therapy in men with high risk prostate cancer: The role of radical prostatectomy as initial treatment - Session Highlights

WASHINGTON, DC USA ( - The initial use of radical prostatectomy (RP) in patients with high-risk prostate cancer (CaP) avoids the need for androgen deprivation therapy (ADT) in many of these patients according to this presentation from the Cleveland Clinic.


They evaluated RP as initial management and whether this minimized use of ADT in patients with high risk localized CaP. The study cohort consisted of 267 men treated by RP between 1998 and 2004. Inclusion criteria were clinical stage >T2b, and/or prostate specific antigen (PSA) ≥15ng/ml, and/or Gleason score ≥8. Assessed outcomes included biochemical recurrence (BCR), distant metastasis (DM), cancer specific survival, and use of ADT.

The study had a mean follow-up of 6.7 years. BCR, DM, and death from prostate cancer were observed in 112 (42%), 28 (10%), and 15 (6%) patients, respectively. Salvage treatment was given in 95 (85%) of 112 patients with BCR. Only 71 (27%) of 267 men were administered ADT. The overall, 10-year probabilities of freedom from BCR, DM, death from prostate cancer, and ADT were 59%, 89%, 94%, and 73%, respectively. They concluded that RP had good long-term oncologic outcomes and 70% of patients in their series avoided use of ADT.


Presented by Eric A. Klein, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA

Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.


The opinions expressed in this article are those of the Contributing Editor and do not necessarily reflect the viewpoints of the American Urological Association.



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