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Advances in Urology
Volume 2012 (2012), Article ID 612707, 6 pages
http://dx.doi.org/10.1155/2012/612707
Research Article

The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis

1Department of Urology and Pediatric Urology, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Oberdü rrbacher Strasse 6, 97080 Wü rzburg, Germany
2Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium
3Department of Urology, University of Turin, 10126 Turin, Italy
4Microarray Unit, University of Würzburg, 97078 Würzburg, Germany
5Department of Urology, Vita-Salute San Raffaele University, 20132 Milan, Italy
6College of Medicine, Mayo Clinic, Rochester, MN 55905, USA
7Department of Urology, Université Catholique De Louvain, 1348 Brussels, Belgium
8Department of Urology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
9Department of Urology, University of Piemonte Orientale, 28100 Novara, Italy
10Department of Urology, Community Hospital Karlsruhe, 76133 Karlsruhe, Germany
11Department of Urology, Erasmus MC, 3015 CE Rotterdam, The Netherlands

Received 15 August 2011; Revised 26 October 2011; Accepted 12 November 2011

Academic Editor: James A. Brown

Copyright © 2012 Maria Schubert et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. To assess the role of adjuvant androgen deprivation therapy (ADT) in high-risk prostate cancer patients (PCa) after surgery. Materials and Methods. The analysis case matched 172 high-risk PCa patients with positive section margins or non-organ confined disease and negative lymph nodes to receive adjuvant ADT (group 1, ) or no adjuvant ADT (group 2, ). Results. Only 11.6% of the patients died, 2.3% PCa related. Estimated 5–10-year clinical progression-free survival was 96.9% (94.3%) for group 1 and 73.7% (67.0%) for group 2, respectively. Subgroup analysis identified men with T2/T3a tumors at low-risk and T3b margins positive disease at higher risk for progression. Conclusion. Patients with T2/T3a tumors are at low-risk for metastatic disease and cancer-related death and do not need adjuvant ADT. We identified men with T3b margin positive disease at highest risk for clinical progression. These patients benefit from immediate adjuvant ADT.