Neoadjuvant hormone therapy before radical prostatectomy: Update on the Memorial Sloan-Kettering Cancer Center trials Journal Article
| Authors: | Fair, W. R.; Rabbani, F.; Bastar, A.; Betancourt, J. |
| Article Title: | Neoadjuvant hormone therapy before radical prostatectomy: Update on the Memorial Sloan-Kettering Cancer Center trials |
| Abstract: | We report here the latest follow-up of the Phase II and III trials evaluating pathologic results and relapse-free survival, as judged by serum prostate specific antigen (PSA), in patients with localized prostate cancer who had radical prostatectomy performed at the Memorial Sloan-Kettering Center (MSKCC) either with or without neoadjuvant hormone therapy (NHT). Pelvic lymphadenectomy (PLND), radical prostatectomy, or both with or without NHT was performed in 141 patients enrolled in a Phase II trial comparing patients receiving NHT with concurrent controls and 140 patients in a randomized Phase III trial. In the Phase II study, there was a significant difference in the pathologic results, with only 35 (49%) of the 72 patients in the control group having organ-confined margin-negative disease compared with 48 (70%) of the 69 patients in the NHT arm (P = 0.0057; χ2 test). With a median follow-up of 57 months, there was no significant difference in the PSA relapse rates in the two arms (P = 0.92; log-rank test). In the Phase III study, 39 (59%) of the 66 patients in the control arm had organ-confined margin-negative disease compared with 52 (70%) of the 74 patients in the NHT arm (P = 0.17; χ2 test). However, the positive-margin rate was significantly lower in the NHT arm (19%) than in the control arm (37%) (P = 0.023; χ2 test). With a median follow-up of 35 months, there was no significant difference in the PSA relapse rates in the two arms (P = 0.73; log-rank test). Thus, although NHT improves the pathologic results, further follow-up is necessary to determine if this marked reduction in the positive- margin rate will translate into improved disease-free survival. |
| Keywords: | adult; cancer survival; controlled study; human tissue; aged; human cell; major clinical study; clinical trial; histopathology; conference paper; cancer staging; prostate specific antigen; controlled clinical trial; phase 2 clinical trial; pelvis lymphadenectomy; prostate cancer; goserelin; prostatectomy; hormonal therapy; phase 3 clinical trial; flutamide; subcutaneous drug administration; human; male; priority journal |
| Journal Title: | Molecular Urology |
| Volume: | 3 |
| Issue: | 3 |
| ISSN: | 1091-5362 |
| Publisher: | Mary Ann Liebert, Inc |
| Date Published: | 1999-01-01 |
| Start Page: | 253 |
| End Page: | 261 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 10851331 |
| DOI/URL: | |
| Notes: | Conference Paper -- Export Date: 16 August 2016 -- Source: Scopus |
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