| 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. | |
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MedLine Citation:
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PMID: 22386416 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Ryan K Berglund; Catherine M Tangen; Isaac J Powell; Bruce A Lowe; Gabriel P Haas; Peter R Carroll; Edith D Canby-Hagino; Ralph Devere White; George P Hemstreet; E David Crawford; Ian M Thompson; Eric A Klein |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Urology Volume: 79 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-03-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 633-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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