Adjuvant Androgen Deprivation Can "Cure" Nonmetastasized Prostate Cancer

March 26, 2007 (Berlin) — An analysis of 5 prospective randomized trials presented here at the European Association of Urology 22nd Annual Congress shows that adjuvant androgen deprivation with early hormone therapy can provide a normal life expectancy and effectively cure a significant proportion of men with M0 prostate cancer.Thomas Ebert, MD, PhD, head of the Department of Urology, EuromedClinic, Fuerth, Germany, initially indicated during his presentation that based on historical data from before the prostate-specific antigen (PSA) era, hormone therapy was believed to be a mainly palliative treatment for advanced prostate cancer. "We know now that adjuvant androgen deprivation following radiation therapy in M0 patients prolongs survival compared with radiation therapy alone," he added.However, Dr. Ebert and colleagues asked whether this early hormone therapy can actually normalize the life expectancy of the patient with nonmetastasized prostate cancer, as with the local interventions of radical prostatectomy and external radiation therapy (EBRT).This analysis used a Medline search to include all published peer-reviewed prospective randomized trials from the past 10 years of the effects of adjuvant castration therapy after local therapy compared with local therapy alone, with median follow-up of more than 5 years. The overall survival (OS) and progression-free survival (PFS) curves were compared with those of age-, time-, and country-matched men without prostate cancer from the Human Mortality Database.Five studies satisfied these inclusion criteria. Differences in OS could be calculated for 3 of these studies, as a comparison with the calculated normal life expectancies: the addition of adjuvant androgen deprivation to EBRT provided an OS that was not significantly different from the normal life expectancies of 70-year-old Belgium men (EORTC 22863) and 69-year-old Swedish men (Granfors), with many, but not all, 70-year-old US men (RTOG 85-31) showing a similar benefit.