Abstract
Objective: To update the results with 10-year data of a phase II prospective trial of neoadjuvant hormonal therapy with goserelin acetate and flutamide followed by radical prostatectomy for locally advanced prostate cancer (SWOG 9109). The optimal management for clinical stage T3 and T4 N0,M0 prostate cancer is uncertain. Materials and Methods: Sixty-two patients with clinical stage T3 and T4 N0,M0 prostate cancer were enrolled. Cases were classified by stage T3 vs T4 and by volume of disease (bulky >4 cm and nonbulky ≤4 cm). Results: Fifty-five of 61 eligible patients completed the trial with radical prostatectomy after neoadjuvant androgen deprivation therapy (ADT). The median preoperative prostate-specific antigen value was 19.8 ng/mL, and 67% of patients had a Gleason score of <7. Among 41 patients last known to be alive, median follow-up is 10.6 years (range 5.1-12.6). In all, 38 patients have had disease progression (30/55, 55%) or died without progression (8/55, 15%) for a 10-year progression-free survival (PFS) estimate of 40% (95% CI 27-53). Median PFS was 7.5 years, and median survival has not been reached. The 10-year overall survival (OS) estimate is 68% (95% CI 56-80). Conclusions: In this small, prospective phase II study, neoadjuvant hormonal therapy with goserelin acetate and flutamide followed by radical prostatectomy achieves long-term PFS and OS comparable with alternative treatments. This approach is feasible and may be an alternative to a strategy of combined radiation and ADT.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 633-637 |
| Number of pages | 5 |
| Journal | Urology |
| Volume | 79 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2012 |
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ASJC Scopus subject areas
- Urology
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Ten-year follow-up of neoadjuvant therapy with goserelin acetate and flutamide before radical prostatectomy for clinical T3 and T4 prostate cancer : Update on southwest oncology group study 9109. / Berglund, Ryan K.; Tangen, Catherine M.; Powell, Isaac J.; Lowe, Bruce A.; Haas, Gabriel P.; Carroll, Peter R.; Canby-Hagino, Edith D.; deVere White, Ralph W; Hemstreet, George P.; Crawford, E. David; Thompson, Ian M.; Klein, Eric A.
In: Urology, Vol. 79, No. 3, 03.2012, p. 633-637.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ten-year follow-up of neoadjuvant therapy with goserelin acetate and flutamide before radical prostatectomy for clinical T3 and T4 prostate cancer
T2 - Update on southwest oncology group study 9109
AU - Berglund, Ryan K.
AU - Tangen, Catherine M.
AU - Powell, Isaac J.
AU - Lowe, Bruce A.
AU - Haas, Gabriel P.
AU - Carroll, Peter R.
AU - Canby-Hagino, Edith D.
AU - deVere White, Ralph W
AU - Hemstreet, George P.
AU - Crawford, E. David
AU - Thompson, Ian M.
AU - Klein, Eric A.
PY - 2012/3
Y1 - 2012/3
N2 - Objective: To update the results with 10-year data of a phase II prospective trial of neoadjuvant hormonal therapy with goserelin acetate and flutamide followed by radical prostatectomy for locally advanced prostate cancer (SWOG 9109). The optimal management for clinical stage T3 and T4 N0,M0 prostate cancer is uncertain. Materials and Methods: Sixty-two patients with clinical stage T3 and T4 N0,M0 prostate cancer were enrolled. Cases were classified by stage T3 vs T4 and by volume of disease (bulky >4 cm and nonbulky ≤4 cm). Results: Fifty-five of 61 eligible patients completed the trial with radical prostatectomy after neoadjuvant androgen deprivation therapy (ADT). The median preoperative prostate-specific antigen value was 19.8 ng/mL, and 67% of patients had a Gleason score of <7. Among 41 patients last known to be alive, median follow-up is 10.6 years (range 5.1-12.6). In all, 38 patients have had disease progression (30/55, 55%) or died without progression (8/55, 15%) for a 10-year progression-free survival (PFS) estimate of 40% (95% CI 27-53). Median PFS was 7.5 years, and median survival has not been reached. The 10-year overall survival (OS) estimate is 68% (95% CI 56-80). Conclusions: In this small, prospective phase II study, neoadjuvant hormonal therapy with goserelin acetate and flutamide followed by radical prostatectomy achieves long-term PFS and OS comparable with alternative treatments. This approach is feasible and may be an alternative to a strategy of combined radiation and ADT.
AB - Objective: To update the results with 10-year data of a phase II prospective trial of neoadjuvant hormonal therapy with goserelin acetate and flutamide followed by radical prostatectomy for locally advanced prostate cancer (SWOG 9109). The optimal management for clinical stage T3 and T4 N0,M0 prostate cancer is uncertain. Materials and Methods: Sixty-two patients with clinical stage T3 and T4 N0,M0 prostate cancer were enrolled. Cases were classified by stage T3 vs T4 and by volume of disease (bulky >4 cm and nonbulky ≤4 cm). Results: Fifty-five of 61 eligible patients completed the trial with radical prostatectomy after neoadjuvant androgen deprivation therapy (ADT). The median preoperative prostate-specific antigen value was 19.8 ng/mL, and 67% of patients had a Gleason score of <7. Among 41 patients last known to be alive, median follow-up is 10.6 years (range 5.1-12.6). In all, 38 patients have had disease progression (30/55, 55%) or died without progression (8/55, 15%) for a 10-year progression-free survival (PFS) estimate of 40% (95% CI 27-53). Median PFS was 7.5 years, and median survival has not been reached. The 10-year overall survival (OS) estimate is 68% (95% CI 56-80). Conclusions: In this small, prospective phase II study, neoadjuvant hormonal therapy with goserelin acetate and flutamide followed by radical prostatectomy achieves long-term PFS and OS comparable with alternative treatments. This approach is feasible and may be an alternative to a strategy of combined radiation and ADT.
UR - http://www.scopus.com/inward/record.url?scp=84857866070&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857866070&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2011.11.019
DO - 10.1016/j.urology.2011.11.019
M3 - Article
C2 - 22386416
AN - SCOPUS:84857866070
VL - 79
SP - 633
EP - 637
JO - Urology
JF - Urology
SN - 1527-9995
IS - 3
ER -