Survival benefits for men treated with local therapies before starting chemotherapy

This study examined the benefits of administering local therapies before chemotherapy for prostate cancer. Researchers reported lower mortality risks for men treated with local therapies before chemotherapy.

Local therapies, such as surgery or radiation, are first-line treatments for localized (confined) prostate cancer. The benefit of local therapies for more advanced prostate cancer is less well understood. This includes localized prostate cancer at high risk of recurrence after treatment and cancer that has spread to other parts of the body (metastatic). Chemotherapy is often recommended in cases of advanced prostate cancer. Whether there is a benefit of administering local therapies before starting chemotherapy is still being investigated.

The aim of this study was to examine the benefits of local therapies for men with prostate cancer who go on to receive chemotherapy.

The records of 1,614 men with localized prostate cancer were included in analysis. All men were treated with chemotherapy for advanced disease (after at least 6 months of hormone therapy). Of these, 17% received radiation therapy before undergoing chemotherapy. 7% were previously treated with prostate surgery and 4% were treated with surgery and radiation. 73% of men received no local therapy before chemotherapy. Patients were followed for an average of 63 months.

The risk of prostate cancer mortality was 35% lower for men treated with surgery with or without radiation compared to no previous local therapy. Prostate cancer-specific mortality was 21% lower for men previously treated with radiation therapy only.

The risk of mortality from any cause was also significantly lower for men previously treated with local therapy. It was 35% lower for men treated with surgery with or without radiation and 24% lower for men previously treated with radiation only.

The time between diagnosis and chemotherapy was significantly longer for men previously treated with surgery and radiation (average 110.7 months) compared to no prior local therapy (48.8 months).

Older age (older than 75 years) and aggressive cancer cells were significant risk factors for mortality due to prostate cancer and mortality from any cause. Having additional medical conditions was not a significant risk factor.

Researchers concluded that mortality risk is reduced for men treated with local therapies before chemotherapy.