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The curative effect of androgen deprivation therapy alone is insufficient in high-risk prostate cancer

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Abstract
To compare the outcomes of patients with high-risk prostate cancer treated by primary radical prostatectomy (RP) and primary androgen deprivation therapy (ADT). The study included patients with high-risk or very high-risk prostate cancer. Patients treated with definitive radiation therapy and those with clinical N1 and M1 disease were excluded. The RP group was divided into sub-cohorts of patients treated with ADT and those who received ADT after biochemical recurrence post-RP. Cancer-specific survival (CSS) and overall survival (OS) were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. The study analyzed 859 patients divided into the RP group (n = 654) and ADT group (n = 205). Castration-resistant prostate cancer was detected in 23 (3.5%) patients in the RP group and 43 (21.0%) patients in the ADT group. Mortality cases included 63 (9.6%) patients in the RP group and 91 (44.4%) patients in the ADT group. CSS (P = .0002) and OS (P < .0001) were significantly higher in the RP group than in the ADT group. In the sub-cohort, CSS did not differ significantly between the RP and ADT groups, whereas OS was significantly higher in the RP group than in the ADT group (P < .0001). In the multivariate analysis, primary ADT increased CSS (hazard ratio, 2.068; P = .0498) and OS (hazard ratio, 3.218; P < .0001) compared with RP. In clinically localized high-risk prostate cancer patients, primary RP was associated with better CSS and OS than primary ADT. Comprehensive counseling in this cohort of patients will help the selection of treatment.
Author(s)
최세영임범진지병훈이원철김정훈경윤수유달산김청수
Issued Date
2021
Type
Article
Keyword
androgen deprivation therapyhigh-risklocalizedprostate cancerprostatectomy
DOI
10.1097/MD.0000000000026833
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7489
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2561924470&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,The%20curative%20effect%20of%20androgen%20deprivation%20therapy%20alone%20is%20insufficient%20in%20high-risk%20prostate%20cancer&amp;offset=0&amp;pcAvailability=true
Publisher
MEDICINE
Location
미국
Language
영어
ISSN
0025-7974
Citation Volume
100
Citation Number
31
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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