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

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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Abstract

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.

Original languageEnglish (US)
Pages (from-to)633-637
Number of pages5
JournalUrology
Volume79
Issue number3
DOIs
StatePublished - Mar 2012

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Goserelin
Flutamide
Neoadjuvant Therapy
Prostatectomy
Prostatic Neoplasms
Disease-Free Survival
Androgens
Survival
Neoplasm Grading
Prostate-Specific Antigen
Disease Progression
Therapeutics
Radiation

ASJC Scopus subject areas

  • Urology

Cite this

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. / Berglund, Ryan K.; Tangen, Catherine M.; Powell, Isaac J.; Lowe, Bruce A.; Haas, Gabriel P.; Carroll, Peter R.; Canby-Hagino, Edith D.; Devere White, Ralph; Hemstreet, George P.; Crawford, E. David; Thompson, Ian M.; Klein, Eric A.

In: Urology, Vol. 79, No. 3, 03.2012, p. 633-637.

Research output: Contribution to journalArticle

Berglund, RK, Tangen, CM, Powell, IJ, Lowe, BA, Haas, GP, Carroll, PR, Canby-Hagino, ED, Devere White, R, Hemstreet, GP, Crawford, ED, Thompson, IM & Klein, EA 2012, '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', Urology, vol. 79, no. 3, pp. 633-637. https://doi.org/10.1016/j.urology.2011.11.019
Berglund, Ryan K. ; Tangen, Catherine M. ; Powell, Isaac J. ; Lowe, Bruce A. ; Haas, Gabriel P. ; Carroll, Peter R. ; Canby-Hagino, Edith D. ; Devere White, Ralph ; Hemstreet, George P. ; Crawford, E. David ; Thompson, Ian M. ; Klein, Eric A. / 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. In: Urology. 2012 ; Vol. 79, No. 3. pp. 633-637.
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abstract = "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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T1 - Ten-year follow-up of neoadjuvant therapy with goserelin acetate and flutamide before radical prostatectomy for clinical T3 and T4 prostate cancer

T2 - Update on southwest oncology group study 9109

AU - Berglund, Ryan K.

AU - Tangen, Catherine M.

AU - Powell, Isaac J.

AU - Lowe, Bruce A.

AU - Haas, Gabriel P.

AU - Carroll, Peter R.

AU - Canby-Hagino, Edith D.

AU - Devere White, Ralph

AU - Hemstreet, George P.

AU - Crawford, E. David

AU - Thompson, Ian M.

AU - Klein, Eric A.

PY - 2012/3

Y1 - 2012/3

N2 - 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.

AB - 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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