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15-year survival outcomes following primary androgen deprivation therapy for localized prostate cancer.
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
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.
Abstracts by Grace L. Lu-Yao:
- Meeting: 2015 ASCO Annual Meeting | Abstract No: 5018
15-year outcomes following conservative management among patients with screen-detected localized prostate cancer.Meeting: 2014 ASCO Annual Meeting | Abstract No: 5053