SURVIVAL AND QUALITY-OF-LIFE OF PATIENTS WITH STAGE D1 (T1-3 PN1-2 M0) PROSTATE-CANCER - RADICAL PROSTATECTOMY PLUS ANDROGEN DEPRIVATION VERSUS ANDROGEN DEPRIVATION ALONE

A series of 139 patients with histologically proven stage D1 (T1-3 pN1 -2 M0) prostate cancer was reviewed in order to determine the influenc e of radical surgery in addition to hormonal treatment on long-term ou tcome with respect to survival and quality of life. In all 139 patient s a pelvic lymphadenectomy was performed. In 87 patients, lymphadenect omy was followed by androgen deprivation alone (group 1). Fifty-two pa tients underwent additional radical prostatectomy (group 2). The actua rial 10-year nonprogression rates were 14.6% in group 1 and 35.8% in g roup 2, respectively (p = 0.0016), The overall and disease-specific 10 -year survival rates were found to be 29.7 and 32.1%, respectively, fo r group 1 and 50.8 and 70.7%, respectively, for group 2. Local progres sion as the main parameter influencing quality of life occurred in 60 of the 87 patients (69%) not subjected to radical prostatectomy. Trans urethral resection of the prostate was required in 29 of these patient s. In contrast, following radical prostatectomy, only 4 of the 52 pati ents (8%) had local progression and only 1 patient (2%) needed a dilat ation of the vesicourethral anastomosis for relief of infravesical obs truction. Thus, radical prostatectomy plus androgen deprivation for pa tients with stage D1 prostate cancer appeared to be superior to androg en deprivation alone with respect to survival expectancy and quality o f life. Prospective randomized trials, however, have to be undertaken to verify these results.