Intermittent androgen deprivation (IAD) in patients with biochemical failure after radical retropubic prostatectomy (RRP) for clinically localized prostate cancer

We report a study in which our objective was to analyze the clinical respon se during IAD in patients with biochemical failure after RRP for clinically localized prostate cancer. Between February 1994 and May 1996, 34 patients who exhibited a primary postoperative decrease in PSA to below the detecti on limit after RRP and then showed PSA progression during follow-up were in cluded as group 1 and 17 patients in whom PSA did not decrease after RRP we re included as group 2. Patients were offered IAD when PSA progressed over 0.4 ng/ml in group 1 and over 4.0 ng/ml in group 2. Median follow-up is 184 weeks in group 1 and 206 weeks in group 2. The median time "off" therapy i ncreased from 25% (1st cycle) to 68.7% (5th cycle) of the entire cycle in g roup 1 and from 33.3% to 58.3% in group 2. Nine out of 12 cases with Gleaso n score greater than or equal to8 failed to respond to IAD and all develope d metastatic and/or local failure. No case with Gleason score <7 failed to respond to IAD. Our conclusions suggest that IAD may be effective in patien ts with biochemical progression after RRP. In our experience, Gleason score seems to be an important variable.