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Primary androgen deprivation therapy not effective in elderly men
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When compared with conservative management, primary androgen deprivation therapy does not improve survival in most elderly men with localized prostate cancer.
In a population-based cohort study, researchers from the Cancer Institute of New Jersey and other New Jersey sites analyzed data from the SEER program database. Men in the study cohort (n=19,271) were diagnosed with T1-T2 cancer between 1992 and 2002 and were aged 66 and older.
Forty-one percent of patients with localized prostate cancer received primary androgen deprivation therapy (n=7,867) and 11,404 received conservative management.
During follow-up, there were 1,560 deaths related to prostate cancer and 11,045 from all causes.
Compared with conservative management, primary androgen deprivation therapy was linked to decreased 10-year prostate cancer-specific survival (82.6% vs. 80.1%; HR=1.17; 95% CI, 1.03-1.33) and no difference in 10-year overall survival (30.3% vs. 30.2%; HR=1.00; 95% CI, 0.96-1.05), according to the researchers.
Primary androgen deprivation therapy was associated with improved prostate cancer-specific survival (59.8% vs. 54.3%; HR=0.84; 95% CI, 0.70-1.00) but not overall survival (17.3% vs. 15.3%; HR=0.92; 95% CI, 0.84-1.01) in a pre-specified subset analysis of men with poorly differentiated cancer. – by Stacey L. Adams
JAMA. 2008;300:173-181.