Theo de Reijke1, Eric Derobert. 1. Department of Urology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Abstract
PURPOSE: Different outcome results have been published in trials comparing maximal androgen blockade (MAB) with chemical or surgical castration alone. The conflicting results could be explained by the fact that patients were included with different prognostic factors. In this new analysis of the Anandron European Study, independent prognostic factors have been evaluated in order to identify those which could influence the study outcome and the impact of the treatment. MATERIAL AND METHODS: 399 out of 457 patients recruited in this study were divided in a good or poor prognostic group depending on the presence of two or more poor prognostic factors, these were pain requiring treatment, >5 bone metastases, hydronephrosis, and alkaline phosphatase >2 ULN. RESULTS: When expressed as a percentage, the improvement in time to progression, overall and cancer specific survival in the Anandron treated patients was identical in both groups. In absolute terms this improvement, however, was greater in the good prognostic group. CONCLUSION: In comparison with surgical castration MAB using Anandron, in patients with metastatic prostate cancer improves the time to objective progression, overall and cancer specific survival, irrespective of certain poor prognostic factors.
RCT Entities:
PURPOSE: Different outcome results have been published in trials comparing maximal androgen blockade (MAB) with chemical or surgical castration alone. The conflicting results could be explained by the fact that patients were included with different prognostic factors. In this new analysis of the Anandron European Study, independent prognostic factors have been evaluated in order to identify those which could influence the study outcome and the impact of the treatment. MATERIAL AND METHODS: 399 out of 457 patients recruited in this study were divided in a good or poor prognostic group depending on the presence of two or more poor prognostic factors, these were pain requiring treatment, >5 bone metastases, hydronephrosis, and alkaline phosphatase >2 ULN. RESULTS: When expressed as a percentage, the improvement in time to progression, overall and cancer specific survival in the Anandron treated patients was identical in both groups. In absolute terms this improvement, however, was greater in the good prognostic group. CONCLUSION: In comparison with surgical castration MAB using Anandron, in patients with metastatic prostate cancer improves the time to objective progression, overall and cancer specific survival, irrespective of certain poor prognostic factors.