Impact of adjuvant androgen deprivation therapy after radical prostatectomy on the survival of patients with pathological T3b prostate cancer.

摘要: OBJECTIVE To determine the impact of adjuvant androgen deprivation therapy (ADT) on survival in patients with seminal vesicle invasion (pT3b) at radical prostatectomy. PATIENTS AND METHODS We reviewed 12,115 who underwent prostatectomy between 1987 and 2002 to identify pT3bN0 prostate cancer received ADT (n= 191). These were matched by clinical pathological variables a group pT3b did not receive ADT. Median postoperative follow-up was 10 years. Clinical endpoints included biochemical progression-free (BPFS), local recurrence-free (LRFS), systemic (SPFS), cancer-specific (CSS) overall survival. RESULTS Patients experienced improved 10-year BPFS (60% vs 16%, P < 0.001), LRFS (87% 76%, P= 0.002), SPFS (91% 78%, 0.004) CSS (94% 87%, 0.037). Overall significantly different groups (75% 69%, 0.12). Both luteinizing hormone-releasing hormone agonists (hazard ratio, 0.26; 95% CI, 0.15-0.46; 0.001) bilateral orchiectomy 0.13; 0.06-0.31; BPFS. When stratified type (hormonal orchiectomy), there no difference outcomes. CONCLUSIONS Adjuvant improves local, control after for cancer. There is receiving medical hormonal undergoing orchiectomy. Given lack improvement survival, continued investigation needed cohort highest risk progression therefore most likely benefit from multimodal treatment approach.