RANDOMIZED, PROSPECTIVE, CONTROLLED-STUDY COMPARING RADICAL PROSTATECTOMY ALONE AND NEOADJUVANT ANDROGEN WITHDRAWAL IN THE TREATMENT OF LOCALIZED PROSTATE-CANCER

Citation
Sl. Goldenberg et al., RANDOMIZED, PROSPECTIVE, CONTROLLED-STUDY COMPARING RADICAL PROSTATECTOMY ALONE AND NEOADJUVANT ANDROGEN WITHDRAWAL IN THE TREATMENT OF LOCALIZED PROSTATE-CANCER, The Journal of urology, 156(3), 1996, pp. 873-877
Citations number
24
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
00225347
Volume
156
Issue
3
Year of publication
1996
Pages
873 - 877
Database
ISI
SICI code
0022-5347(1996)156:3<873:RPCCRP>2.0.ZU;2-#
Abstract
Purpose: A prospective, multicenter, randomized study was done to test the hypothesis that neoadjuvant androgen withdrawal decreases the inc idence of positive margins following radical prostatectomy for localiz ed prostate cancer. Materials and Methods: Observations were made of 2 13 patients randomized to undergo radical prostatectomy alone (101) or to receive a 12-week course of 300 mg, cyproterone acetate daily foll owed by surgery (112). Groups were similar at baseline in terms of cli nical stage, serum prostate specific antigen and Gleason score, Of 192 patients available for efficacy analysis 9 had stage T1b, 8 stage T1c , 63 stage T2a, 36 stage T2b and 76 stage T2c disease. Results: One or more positive surgical margins were found in 59 of 91 patients (64.8% ) in the surgery only group compared to 28 of 101 (27.7%) in the cypro terone acetate group (p = 0.001). Patients who received preoperative t herapy had a statistically significantly lower rate of apical margin i nvolvement than those who did not (17.8 versus 47.8%, respectively, p <0.0001). There was no statistically significant difference in surgica l (p = 0.8645) or postoperative (p = 0.173) complications between the 2 groups. Conclusions: Neoadjuvant androgen withdrawal with a 12-week course of 300 mg, cyproterone acetate daily results in a lower rate of positive margins without adversely affecting postoperative recovery. The impact on patient survival will be determined by long-term followu p.