Al. Potosky et al., Quality-of-life outcomes after primary androgen deprivation therapy: Results from the prostate cancer outcomes study, J CL ONCOL, 19(17), 2001, pp. 3750-3757
Purpose : To compare health-related quality-of-life outcomes after primary
androgen deprivation (AD) therapy with orchiectomy versus luteinizing hormo
ne-releasing hormone (LHRH) agonists for patients with prostate cancer.
Patients and Methods: Men (n = 431) newly diagnosed with all stages of pros
tate cancer from six geographic regions who participated in the Prostate Ca
ncer Outcomes Study and who received primary AD therapy but no other treatm
ents within 12 months of initial diagnosis were included in a study of heal
th outcomes. Comparisons were statistically adjusted for patient sociodemog
raphic and clinical characteristics, timing of therapy, and use of combined
androgen blockade.
Results: More than half of the patients receiving primary AD therapy had be
en initially diagnosed with clinically localized prostate cancer. Among the
se patients, almost two thirds were at high risk of progression on the basi
s of prognostic factors. Sexual function outcomes were similar by treatment
group both before and after implementation of AD therapy. LHRH patients re
ported more breast swelling than did orchiectomy patients (24.9% v 9.7%, P
< .01). LHRH patients reported more physical discomfort and worry because o
f cancer or its treatment than did orchiectomy patients. LHRH patients asse
ssed their overall health as fair or poor more frequently than did orchiect
omy patients (35.4% v 28.1%, P = .01) and also were less likely to consider
themselves free of prostate cancer after treatment.
Conclusion: Most endocrine-related health outcomes are similar after surgic
al versus medical primary hormonal therapy. Stage at diagnosis had little e
ffect on outcomes. These results provide representative information compari
ng surgical and medical AD therapy that may be used by physicians and patie
nts to inform treatment decisions. (C) 2001 by American Society of Clinical
Oncology.