Failure after primary radiation or surgery for prostate cancer: Differences in response to androgen ablation

Gregory P Swanson, Mark Riggs, John Earle

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: Androgen ablation is the standard treatment for recurrent and metastatic prostate cancer. Surprisingly few studies have documented the specific results for local and distant failure in patients treated primarily with radiation or radical prostatectomy. We report the long-term outcome of a series of those patients. Materials and Methods: We followed until death 94 patients in whom primary radiation therapy failed and 67 in whom radical prostatectomy failed. All patients received androgen ablation. Results: Statistically (p = 0.04) more patients in the radiation group (78%) died of prostate cancer than in the radical prostatectomy group (63%). Of the radiation group with local failure alone 63%, died of prostate cancer at a median of 5.03 years. Of the surgery group with isolated local failure 50% died of cancer at a median of 9.83 years. Of the patients treated with radiation with distant metastasis 93% died of cancer with a median time to death of 2.34 years. Of the patients treated with surgery 69% died of prostate cancer at a median of 3.27 years. The differences in survival between the 2 groups was significant. Conclusions: This study is unique in providing followup until death of patients treated with radical prostatectomy and radiation who had clinical failure and were treated with androgen ablation. Compelling is the finding that survival after androgen ablation after surgical failure is superior to that for radiation. If confirmed, this would be a significant consideration for future studies of patients in whom primary therapy fails.

Original languageEnglish (US)
Pages (from-to)525-528
Number of pages4
JournalJournal of Urology
Volume172
Issue number2
DOIs
StatePublished - Aug 2004
Externally publishedYes

Fingerprint

Androgens
Prostatic Neoplasms
Radiation
Prostatectomy
Survival
Neoplasms
Radiotherapy
Neoplasm Metastasis
Therapeutics

Keywords

  • Androgens
  • Prostatectomy
  • Prostatic neoplasms
  • Radiotherapy

ASJC Scopus subject areas

  • Urology

Cite this

Failure after primary radiation or surgery for prostate cancer : Differences in response to androgen ablation. / Swanson, Gregory P; Riggs, Mark; Earle, John.

In: Journal of Urology, Vol. 172, No. 2, 08.2004, p. 525-528.

Research output: Contribution to journalArticle

Swanson, Gregory P ; Riggs, Mark ; Earle, John. / Failure after primary radiation or surgery for prostate cancer : Differences in response to androgen ablation. In: Journal of Urology. 2004 ; Vol. 172, No. 2. pp. 525-528.
@article{c01c799bff304a49b1fd91e3c4cd54f4,
title = "Failure after primary radiation or surgery for prostate cancer: Differences in response to androgen ablation",
abstract = "Purpose: Androgen ablation is the standard treatment for recurrent and metastatic prostate cancer. Surprisingly few studies have documented the specific results for local and distant failure in patients treated primarily with radiation or radical prostatectomy. We report the long-term outcome of a series of those patients. Materials and Methods: We followed until death 94 patients in whom primary radiation therapy failed and 67 in whom radical prostatectomy failed. All patients received androgen ablation. Results: Statistically (p = 0.04) more patients in the radiation group (78{\%}) died of prostate cancer than in the radical prostatectomy group (63{\%}). Of the radiation group with local failure alone 63{\%}, died of prostate cancer at a median of 5.03 years. Of the surgery group with isolated local failure 50{\%} died of cancer at a median of 9.83 years. Of the patients treated with radiation with distant metastasis 93{\%} died of cancer with a median time to death of 2.34 years. Of the patients treated with surgery 69{\%} died of prostate cancer at a median of 3.27 years. The differences in survival between the 2 groups was significant. Conclusions: This study is unique in providing followup until death of patients treated with radical prostatectomy and radiation who had clinical failure and were treated with androgen ablation. Compelling is the finding that survival after androgen ablation after surgical failure is superior to that for radiation. If confirmed, this would be a significant consideration for future studies of patients in whom primary therapy fails.",
keywords = "Androgens, Prostatectomy, Prostatic neoplasms, Radiotherapy",
author = "Swanson, {Gregory P} and Mark Riggs and John Earle",
year = "2004",
month = "8",
doi = "10.1097/01.ju.0000132412.74468.57",
language = "English (US)",
volume = "172",
pages = "525--528",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Failure after primary radiation or surgery for prostate cancer

T2 - Differences in response to androgen ablation

AU - Swanson, Gregory P

AU - Riggs, Mark

AU - Earle, John

PY - 2004/8

Y1 - 2004/8

N2 - Purpose: Androgen ablation is the standard treatment for recurrent and metastatic prostate cancer. Surprisingly few studies have documented the specific results for local and distant failure in patients treated primarily with radiation or radical prostatectomy. We report the long-term outcome of a series of those patients. Materials and Methods: We followed until death 94 patients in whom primary radiation therapy failed and 67 in whom radical prostatectomy failed. All patients received androgen ablation. Results: Statistically (p = 0.04) more patients in the radiation group (78%) died of prostate cancer than in the radical prostatectomy group (63%). Of the radiation group with local failure alone 63%, died of prostate cancer at a median of 5.03 years. Of the surgery group with isolated local failure 50% died of cancer at a median of 9.83 years. Of the patients treated with radiation with distant metastasis 93% died of cancer with a median time to death of 2.34 years. Of the patients treated with surgery 69% died of prostate cancer at a median of 3.27 years. The differences in survival between the 2 groups was significant. Conclusions: This study is unique in providing followup until death of patients treated with radical prostatectomy and radiation who had clinical failure and were treated with androgen ablation. Compelling is the finding that survival after androgen ablation after surgical failure is superior to that for radiation. If confirmed, this would be a significant consideration for future studies of patients in whom primary therapy fails.

AB - Purpose: Androgen ablation is the standard treatment for recurrent and metastatic prostate cancer. Surprisingly few studies have documented the specific results for local and distant failure in patients treated primarily with radiation or radical prostatectomy. We report the long-term outcome of a series of those patients. Materials and Methods: We followed until death 94 patients in whom primary radiation therapy failed and 67 in whom radical prostatectomy failed. All patients received androgen ablation. Results: Statistically (p = 0.04) more patients in the radiation group (78%) died of prostate cancer than in the radical prostatectomy group (63%). Of the radiation group with local failure alone 63%, died of prostate cancer at a median of 5.03 years. Of the surgery group with isolated local failure 50% died of cancer at a median of 9.83 years. Of the patients treated with radiation with distant metastasis 93% died of cancer with a median time to death of 2.34 years. Of the patients treated with surgery 69% died of prostate cancer at a median of 3.27 years. The differences in survival between the 2 groups was significant. Conclusions: This study is unique in providing followup until death of patients treated with radical prostatectomy and radiation who had clinical failure and were treated with androgen ablation. Compelling is the finding that survival after androgen ablation after surgical failure is superior to that for radiation. If confirmed, this would be a significant consideration for future studies of patients in whom primary therapy fails.

KW - Androgens

KW - Prostatectomy

KW - Prostatic neoplasms

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=3142652013&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3142652013&partnerID=8YFLogxK

U2 - 10.1097/01.ju.0000132412.74468.57

DO - 10.1097/01.ju.0000132412.74468.57

M3 - Article

C2 - 15247720

AN - SCOPUS:3142652013

VL - 172

SP - 525

EP - 528

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -