Radical Prostatectomy Superior to Androgen Deprivation Therapy in Treating Localized Prostate Cancer

June 12, 2012 by  
Filed under Prostate Cancer News

A prostate cancer study has revealed that Radical Prostatectomy (RP) is superior to the use of Primary Androgen Deprivation Therapy (PADT) when treating localized prostate cancer. These findings were based on research conducted through the Surveillance Epidemiology and End Results (SEER).

According the summary of the report, men with localized prostate cancer are more likely to die the condition and any other factors within three years if they are treated with primary androgen deprivation therapy (PADT). The details about this new research and how the findings were arrived at are provided below:

Patients with localized prostate cancer (PCa) are more likely to die from any cause and from PCa within three years if they undergo primary androgen deprivation therapy (PADT) rather than radical prostatectomy (RP), a new study indicates.

Researchers used information from the linked Surveillance Epidemiology and End Results (SEER)-Medicare database from 1998 to 2007 to probe the comparative effectiveness of PADT and RP. Using propensity-score matching to control for the most important survival predictors, they determined that PADT was associated with a threefold higher risk of overall mortality and a 12-fold higher risk of PCa-specific mortality within the follow-up period, which averaged 2.87 years for patients who underwent PADT and 2.95 years for RP patients.

“ADT alone is not appropriate for localized PCa patients,” noted lead investigator Jinan Liu, PhD, of HealthCore, Inc., in Wilmington, Del., after presenting the results at the 2012 annual meeting of the International Society for Pharmacoeconomics and Outcomes Research. “The patients should be well informed by their physician about this knowledge before making treatment decision together.”

Dr. Liu and three of his coauthors from Tulane University in New Orleans undertook the study because PADT is commonly used in localized PCa but does not have a solid evidence base behind this treatment. Their analysis focused on patients aged 66-74 years at the time of diagnosis and who had T1 or T2 PCa and no other cancer diagnosis.

The study included 1,624 patients with localized PCa treated with PADT and another 1,624 who underwent RP. The two groups were comparable with respect to Gleason score, Charlson Comorbidity Index score, PSA levels, age, race, and year of treatment initiation.

During the follow-up period, the rates of overall mortality and PCa-specific mortality were 16.38% and 3.69%, respectively, in the PADT group compared with 3.45% and 0.25%, respectively, in the RP group.

Patients who were unmarried or had more comorbidities were the most likely to die. Poor Gleason scores were associated with the highest risk of PCa-specific death.

Dr. Liu noted that the results are congruent with an earlier study he led (Comp Effectiveness Res 2012;2:21-27) showing that, after propensity-score matching, three-year overall survival in localized-PCa was significantly lower with PADT than with RP. Source.

The above results are not surprising because for a longtime other studies have revealed that early stage prostate cancer or localized prostate cancer can be treated effectively with surgery. Also, many more studies have also confirmed that hormone therapy like the Primary Androgen Deprivation Therapy (PADT) is very effective with advanced or metastatic prostate cancer.

However, the above study is more or less comparative study between the effectiveness of RP and PADT. It further has supported earlier studies and can help researchers to concentrate more of these treatments to a particular stage. Doing this will help increase the survival rates of men treated for cancer of the prostate.

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