Androgen Ablation Response Varies in Metastatic Prostate Cancer

NEW YORK (Reuters Health) Sept 27 - Prostate cancer patients who undergo
androgen ablation after radical prostatectomy failure appear to survive
longer than similar patients in whom primary radiation has failed,
according to a new study.

In the August issue of the Journal of Urology, Dr. Gregory P. Swanson of
Cancer Care Northwest, Spokane, Washington and colleagues point out that
despite the widespread use of androgen ablation for metastatic prostate
cancer, "detailed evaluation of response to treatment for failure after
surgery or radiation is lacking."

To shed more light on the matter, the researchers followed 94 patients
in whom primary radiation therapy had failed and 67 in whom radical
prostatectomy had failed. All underwent androgen ablation. Follow-up
lasted for as long as 29 years.

Significantly more patients in the radiation group (78%) died of
prostate cancer than did patients in the prostatectomy group (63%).

Of those in the radiation group with local failure alone, 63% died of
cancer at median of 5.03 years. In the surgery group, 50% of such
patients died at a median of 9.83 years.

In total, 93% of the radiation patients with distant metastases died of
cancer in a median of 2.34 years. In the corresponding surgery group,
the proportion was 50.0% at a median of 3.27 years.

Should these findings be confirmed, the researchers conclude that "this
would be a significant consideration for future studies of patients in
whom primary therapy fails."

J Urol 2004;172:525-528.