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Primary ADT failed to extend survival in prostate cancer
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Men with early-stage prostate cancer who undergo primary androgen deprivation therapy instead of surgery or radiation do not survive longer than those who receive no treatment, according to results of a retrospective cohort study.
Researchers used a cancer registry linked to three integrated health plans to evaluate data on 15,170 men diagnosed with clinically localized prostate cancer between 1995 and 2008. The patients did not undergo surgery or radiation. Follow-up continued through December 2010.
All-cause and prostate cancer-specific mortality served as the primary outcome.
The researchers used Cox proportional hazards models, with and without propensity score analysis, to evaluate the relationship between primary ADT and mortality.
After adjustments for sociodemographic and clinical traits, researchers observed no correlation between primary ADT and all-cause mortality (HR=1.04; 95% CI, 0.97-1.11) or prostate cancer-specific mortality (HR=1.03; 95% CI, 0.89-1.19).
Researchers only was associated with a reduced risk of all-cause mortality among men with a high risk for cancer progression (HR=0.88; 95% CI, 0.78-0.97).
Primary ADT — the second most common treatment for early-stage prostate cancer — may be an attractive option for slowing prostate cancer progression in men who are poor candidates for surgery or radiation, or those who may want to avoid the adverse effects of these treatments, according to study investigator Arnold Potosky, PhD, professor of oncology and director of health services research at Georgetown Lombardi Comprehensive Cancer Center.
“Primary androgen deprivation therapy may be preferable to some men with early-stage prostate cancer who would prefer to do something rather than watch and wait for further signs of progression to occur later and then need treatments,” Potosky said in a press release. “However, using primary ADT by itself immediately after diagnosis in the hopes of limiting cancer’s progression does not extend survival, according to this study.”
Disclosure: The researchers report no relevant financial disclosures.
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