In a nutshell
This study examined factors important in the treatment of localized prostate cancer with androgen deprivation therapy (ADT). Researchers reported a number of specific markers that can help determine the risk of cancer progression after ADT.
Some background
Androgen deprivation therapy (ADT) is a type of hormone therapy that targets the production of male hormones (such as testosterone). Reducing androgen levels and their effect on cancer cell growth can dramatically improve survival. ADT is currently the standard of care for advanced prostate cancer or cancer that has begun to spread. It is less commonly used for cancer confined to the prostate gland (localized prostate cancer). Further studies are needed to help determine treatment outcome with ADT for localized prostate cancer.
Methods & findings
The aim of this study was to examine the effects of ADT as a first-line treatment for localized prostate cancer.
This study analyzed the records of 649 men with localized or locally advanced prostate cancer. All men received ADT as a first-line treatment. Men were divided according to standardized risk of cancer recurrence after treatment (low, intermediate, or high). Treatment outcomes were followed for an average of 49 months.
The 5-year overall survival rate (proportion who have not died from any cause since treatment) was 91.9%. Cancer-specific survival (proportion who have not died from prostate cancer since treatment) was 97.9%.
5-year cancer progression rates (based on blood tests) were lowest among low-risk cancer patients. 80.7% of low-risk patients did not show signs of cancer progression. In comparison, 78.5% of intermediate-risk and 63.8% of high-risk patients did not show cancer progression at 5 years. However, these differences were not statistically significant.
Having tumors on both lobes of the prostate, a high Gleason score (indicating more aggressive cancer cells), locally advanced disease, and blood tests showing prostate growth were all risk factors for cancer progression. A new risk-classification based on these specific factors showed significant differences between risk groups. 5-year cancer progression rates were 78.2% for low-risk, 62.5% for intermediate-risk, and 46.9% for high-risk patients.
The bottom line
The researchers concluded that certain factors can determine the risk of prostate cancer progression following ADT in men with localized disease.
The fine print
Randomized clinical trials are needed before ADT can be recommended as a first-line treatment for localized prostate cancer.
Published By :
BMC cancer
Date :
May 20, 2015
