Fujimoto Naohiro
   Department   School of Medicine  Urology, Clinical Medical Sciences
   Position  
Article types journal article
Language English
Peer review Non peer reviewed
Title Cessation of Primary Androgen Deprivation Therapy for Men With Localized Prostate Cancer.
Journal Formal name:Clinical genitourinary cancer
Abbreviation:Clin Genitourin Cancer
ISSN code:19380682/15587673
Domestic / ForeginForegin
Volume, Issue, Page 13(4),359-63頁
Author and coauthor Fujimoto Naohiro, Kubo Tatsuhiko, Tomisaki Ikko
Publication date 2015/08
Summary INTRODUCTION:Substantial numbers of men with localized prostate cancer undergo long-term primary androgen deprivation therapy (ADT). Whether long-term ADT is required for patients with localized prostate cancer, especially elderly men, remains unknown. In the present study, we explored the possibility of ADT cessation after a favorable response to primary ADT in patients with localized prostate cancer.PATIENTS AND METHODS:We retrospectively reviewed men with localized prostate cancer who had achieved a good initial response to primary ADT and stopped it thereafter. Prostate-specific antigen (PSA) recurrence was defined as 2 consecutive increases > 4 ng/mL. A total of 34 patients (age, 62-89 years) were followed up for > 24 months after ADT cessation.RESULTS:The ADT duration and follow-up period after ADT cessation was 10 to 162 months (median, 33.5 months) and 24 to 95 months (median, 37 months), respectively. PSA recurrence was observed in 10 of 34 patients (29.4%), and the 5-year PSA progression-free rate was 66.2%. PSA recurrence was observed in 100% (6 of 6) and 14.3% (4 of 28) of men who had received ADT for < 16 months and > 16 months, respectively. ADT was reinstated in 5 patients after PSA recurrence; and their PSA levels declined rapidly, and no clinical progression was observed. The 5-year overall and disease-specific survival rate was 65.1% and 100%, respectively.CONCLUSION:ADT can be stopped for men with localized prostate cancer, especially elderly men, after a favorable response to primary ADT.
DOI 10.1016/j.clgc.2015.02.013
PMID 25907231