ART Eur Urol Duration of Androgen Deprivation Therapy Outcomes DM PCSM
Objective: To determine if the duration of ADT influences clinical outcomes for men receiving it post-RP RT.
Design, setting, and participants: A total of 680 men had a median follow-up post-RT was 57.8 mo.
Outcome measurements and statistical analysis: Biochemical failure (BF), distant metastasis (DM), prostate cancer-specific mortality (PCSM), and overall mortality were assessed.
Results and limitations: Patients who received <12 mo of ADT had an association with increased BF (hazard ratio [HR]: 2.27; p=0.003) and DM (HR: 2.48; p-0.03) compared with patients receiving >12 mo of ADT. Each month of ADT was associated with a decreased risk for BF (HR: 0.95; p=0.0004), DM (HR: 0.88; p=0.0004), and PCSM (HR: 0.90; p-0.037).
My Analysis: The hazard ratios (HR) for the difference in BF (227% more) and DM (248% more) between patients on ADT less than, versus more than, 12 months are dramatic. Also, each month a patient remains on ADT improves their odds against BF, DM and PCSM…not sure how to aggregate these benefits over time, but the ‘p’ values for BF and DM are convincing (‘p’ being the % probability that a random chance generated the data ).
I have also looked a three other studies done more recently (with the advent of better RT techniques) showing 18 months is as good as 24 to 36 months, but the HR’s noted on the studies were at best .74…not good enough for me to risk this disease coming back. In the end I will rely on medical studies; otherwise we are all trapped in a world of anecdotes and we have nothing to rely on, other than our Doctor’s prognosis…which is back to square one for me…
ART: Eur Urol. 2016 Jan;69(1):50-7, doi: 10.1016/j.eururo.2015.05.009. Epub 2015 May 21
