129306-144

15-year survival outcomes following primary androgen deprivation therapy for localized prostate cancer.

Subcategory: 
Category: 
Genitourinary (Prostate) Cancer
Session Type and Session Title: 
Poster Highlights Session, Genitourinary (Prostate) Cancer
Abstract Number: 
5033
Citation: 
J Clin Oncol 32:5s, 2014 (suppl; abstr 5033)
Author(s): 
Grace L. Lu-Yao, Peter C. Albertsen, Dirk Moore, Weichung Shih, Yong Lin, Robert S. DiPaola, Siu-Long Yao; Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; University of Connecticut Health Center, Farmington, CT; Rutgers Cancer Institute of New Jersey, The School of Public Health, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Rutgers Biomedical and Health Sciences, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures

Abstract: 

Background: Primary androgen deprivation therapy (ADT) for early stage prostate cancer has been widely utilized for localized prostate cancer, especially among older patients, despite a lack of data supporting its use. This study presents long-term survival outcomes following primary ADT in older men with localized (T1/T2) prostate cancer as a follow up to our prior study. Methods: Instrumental variable analysis was used to assess the impact of primary ADT in a population-based cohort consisting of residents in areas covered by the Surveillance, Epidemiology, and End Results (SEER) Program. Results: The cohort consisted of 66,717 patients aged ≥66 years diagnosed in 1992-2009 who received no definitive local therapy within 180 days of prostate cancer diagnosis. After a median follow-up of 9.2 years, primary ADT was not associated with improved 15-year overall or prostate cancer-specific survival. Among patients with moderately differentiated cancers, 15-year overall survival was 20.0% in high-use regions vs. 20.8% in low-use regions (difference 95% CI -2.2% to 0.4%), and 15-year prostate cancer survival was 90.6% in both high- and low- use regions (difference 95% CI -1.1% to 1.2%). Among patients with poorly differentiated cancers, the 15-year cancer-specific survival was 78.6% in high-use regions versus 78.5%, in low-use regions (difference 95% CI -1.8% to 2.4%), and 15-year overall survival was 8.6% in high-use regions vs. 9.2% in low-use regions (difference 95% CI -1.5% to 0.4%). Conclusions: Primary ADT is not associated with improved long-term overall or disease-specific survival for localized prostate cancer.