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Impact of Early Salvage Androgen Deprivation Therapy in Localized Prostate Cancer after Radical Prostatectomy: A Propensity Score Matched Analysis

 Jae Won Park  ;  Won Sik Jang  ;  Dong Hoon Koh  ;  Won Sik Ham  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Young Deuk Choi 
 Yonsei Medical Journal, Vol.59(5) : 580-587, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
Aged ; Androgen Antagonists/*therapeutic use ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Local/pathology/surgery Neoplasm Recurrence ; Neoplasm Staging ; Propensity Score ; Prostate-Specific Antigen ; Prostatectomy/*methods ; Prostatic Neoplasms/mortality/pathology/*therapy ; Regression Analysis ; Retrospective Studies ; Salvage Therapy/*methods ; Survival Rate ; Treatment Outcome
Radical prostatectomy ; androgen deprivation therapy ; prostate specific antigen ; salvage therapy
PURPOSE: Androgen deprivation therapy (ADT) is used as a salvage treatment for men with biochemical recurrence (BCR) of prostate cancer (PCa) following initial radical prostatectomy (RP). The optimal time at which to begin salvage ADT (sADT) remains controversial. In this retrospective study, we evaluated the efficacy of initiating sADT in patients before prostate-specific antigen (PSA) values met the clinical definition of BCR. MATERIALS AND METHODS: We identified 484 PCa patients who received sADT for BCR after RP. Median follow-up was 82 months. Propensity score matching was performed based on preoperative PSA level, pathologic T stage, and Gleason score. Patients were assigned to two groups of 169 patients each, based on PSA levels at the time of sADT: Group A (without meeting of the definition of BCR) and Group B (after BCR). Kaplan-Meier survival analyses and Cox regression analyses were performed. RESULTS: The median PSA level at sADT initiation was 0.12 ng/mL in group A and 0.42 ng/mL in group B. Kaplan-Meier analyses showed that group A had favorable disease progression-free survival (DPFS) and distant metastasis-free survival (DMFS), but did not have better cancer-specific survival (CSS) than group B. In subgroup analyses, group A showed better CSS rates in the non-organ confined PCa group. In Cox regression analyses, early sADT was associated significantly with DPFS and DMFS rates, however, did not correlate with CSS (p=0.107). CONCLUSION: Early sADT after RP improved DPFS and DMFS. Furthermore, early sADT patients demonstrated better CSS in non-organ confined PCa.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
고동훈(Koh, Dong Hoon)
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박재원(Park, Jae Won)
장원식(Jang, Won Sik) ORCID logo https://orcid.org/0000-0002-9082-0381
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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