Androgen Deprivation Not Helpful for Most Prostate Cancers

Therapy not associated with improved survival among majority of elderly men

TUESDAY, July 8 (HealthDay News) -- Androgen deprivation therapy for localized prostate cancer does not improve survival except in the case of poorly differentiated cancers, according to a report in the July 9 issue of the Journal of the American Medical Association.

Grace L. Lu-Yao, Ph.D., from the University of Medicine and Dentistry of New Jersey in Piscataway, and colleagues examined the association between primary androgen deprivation therapy and survival in 19,271 elderly men who did not receive radiation or surgery within six months of diagnosis of localized prostate cancer (stage T1-T2). Of these, 41 percent received androgen deprivation therapy and the remainder received conservative management.

After a median follow-up of 81 months, the researchers found that there were 1,560 prostate cancer deaths and 11,045 deaths from all causes. Androgen deprivation therapy was associated with lower 10-year prostate cancer-specific survival (80.1 versus 82.6 percent, hazard ratio 1.17) and no difference in 10-year overall survival (30.2 versus 30.3 percent, HR 1.00). However, androgen deprivation therapy for poorly differentiated cancers was associated with better prostate cancer-specific survival (59.8 versus 54.3 percent, HR 0.84) but not overall survival (17.3 versus 15.3 percent, HR 0.92).

"Primary androgen deprivation therapy is not associated with improved survival among the majority of elderly men with localized prostate cancer when compared with conservative management," Lu-Yao and colleagues conclude.

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