Adjuvant hormone therapy after radical prostatectomy in highrisk localized and locally advanced prostate cancer: First multicenter, observational study in China
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摘要
Objective: Potential of combined androgen blockade(CAB) has not been explored extensively in Chinese males with prostate cancer(PCa). Therefore, this study evaluated the 2-year prostate-specific antigen(PSA) recurrence rate and quality of life(Qo L) in patients with high-risk localized and locally advanced PCa receiving adjuvant hormone therapy(HT) after radical prostatectomy(RP).Methods: This prospective, multicenter, observational study conducted in 18 centers across China enrolled patients with high-risk factor(preoperative PSA>20 ng/m L or Gleason score >7) or locally advanced PCa. Different adjuvant HT were administered after RP according to investigator's decision in routine clinical practice.Relationship of baseline and postoperative characteristics was assessed with recurrence rate. PSA recurrence rate and Functional Assessment of Cancer Therapy-Prostate(FACT-P) Qo L scores were recorded at 12 months and 24 months. Kaplan-Meier analysis was used to construct the PSA recurrence rate during follow-up.Results: A total of 189 patients(mean age: 66.9±6.5 years) were recruited, among which 112(59.3%) patients showed serum PSA>20 ng/m L preoperatively. The highest postoperative pathological advancement noticed was from clinical T2(c T2) to pathological T3(p T3)(43.9%) stage. The majority of the patients(66.1%) received CAB as adjuvant HT, for a median duration of 20.0 months. The least recurrence(15.2%) was noticed in patients treated with CAB, followed by those treated with luteinizing hormone-releasing hormone agonist(LHRHa)(16.1%), and antiandrogen(19.0%), with non-significant difference noted among the groups. None of the baseline or postoperative characteristics was related with PSA recurrence in our study. The 24-month FACT-P Qo L score of119 patients treated for >12 months showed significant improvement above baseline compared with those treated for ≤12 months.Conclusions: Adjuvant CAB therapy after RP showed reduction trend in 2-year PSA recurrence rate in highrisk Chinese patients with localized and locally advanced PCa, compared with adjuvant anti-androgens(AA) or LHRHa therapy. Further long-term therapy(>12 months) significantly improved Qo L compared to short-term HT therapy, suggesting the beneficial effect of long-term CAB therapy in improving Qo L.
Objective: Potential of combined androgen blockade(CAB) has not been explored extensively in Chinese males with prostate cancer(PCa). Therefore, this study evaluated the 2-year prostate-specific antigen(PSA) recurrence rate and quality of life(Qo L) in patients with high-risk localized and locally advanced PCa receiving adjuvant hormone therapy(HT) after radical prostatectomy(RP).Methods: This prospective, multicenter, observational study conducted in 18 centers across China enrolled patients with high-risk factor(preoperative PSA>20 ng/m L or Gleason score >7) or locally advanced PCa. Different adjuvant HT were administered after RP according to investigator's decision in routine clinical practice.Relationship of baseline and postoperative characteristics was assessed with recurrence rate. PSA recurrence rate and Functional Assessment of Cancer Therapy-Prostate(FACT-P) Qo L scores were recorded at 12 months and 24 months. Kaplan-Meier analysis was used to construct the PSA recurrence rate during follow-up.Results: A total of 189 patients(mean age: 66.9±6.5 years) were recruited, among which 112(59.3%) patients showed serum PSA>20 ng/m L preoperatively. The highest postoperative pathological advancement noticed was from clinical T2(c T2) to pathological T3(p T3)(43.9%) stage. The majority of the patients(66.1%) received CAB as adjuvant HT, for a median duration of 20.0 months. The least recurrence(15.2%) was noticed in patients treated with CAB, followed by those treated with luteinizing hormone-releasing hormone agonist(LHRHa)(16.1%), and antiandrogen(19.0%), with non-significant difference noted among the groups. None of the baseline or postoperative characteristics was related with PSA recurrence in our study. The 24-month FACT-P Qo L score of119 patients treated for >12 months showed significant improvement above baseline compared with those treated for ≤12 months.Conclusions: Adjuvant CAB therapy after RP showed reduction trend in 2-year PSA recurrence rate in highrisk Chinese patients with localized and locally advanced PCa, compared with adjuvant anti-androgens(AA) or LHRHa therapy. Further long-term therapy(>12 months) significantly improved Qo L compared to short-term HT therapy, suggesting the beneficial effect of long-term CAB therapy in improving Qo L.
Objective: Potential of combined androgen blockade(CAB) has not been explored extensively in Chinese males with prostate cancer(PCa). Therefore, this study evaluated the 2-year prostate-specific antigen(PSA) recurrence rate and quality of life(Qo L) in patients with high-risk localized and locally advanced PCa receiving adjuvant hormone therapy(HT) after radical prostatectomy(RP).Methods: This prospective, multicenter, observational study conducted in 18 centers across China enrolled patients with high-risk factor(preoperative PSA>20 ng/m L or Gleason score >7) or locally advanced PCa. Different adjuvant HT were administered after RP according to investigator's decision in routine clinical practice.Relationship of baseline and postoperative characteristics was assessed with recurrence rate. PSA recurrence rate and Functional Assessment of Cancer Therapy-Prostate(FACT-P) Qo L scores were recorded at 12 months and 24 months. Kaplan-Meier analysis was used to construct the PSA recurrence rate during follow-up.Results: A total of 189 patients(mean age: 66.9±6.5 years) were recruited, among which 112(59.3%) patients showed serum PSA>20 ng/m L preoperatively. The highest postoperative pathological advancement noticed was from clinical T2(c T2) to pathological T3(p T3)(43.9%) stage. The majority of the patients(66.1%) received CAB as adjuvant HT, for a median duration of 20.0 months. The least recurrence(15.2%) was noticed in patients treated with CAB, followed by those treated with luteinizing hormone-releasing hormone agonist(LHRHa)(16.1%), and antiandrogen(19.0%), with non-significant difference noted among the groups. None of the baseline or postoperative characteristics was related with PSA recurrence in our study. The 24-month FACT-P Qo L score of119 patients treated for >12 months showed significant improvement above baseline compared with those treated for ≤12 months.Conclusions: Adjuvant CAB therapy after RP showed reduction trend in 2-year PSA recurrence rate in highrisk Chinese patients with localized and locally advanced PCa, compared with adjuvant anti-androgens(AA) or LHRHa therapy. Further long-term therapy(>12 months) significantly improved Qo L compared to short-term HT therapy, suggesting the beneficial effect of long-term CAB therapy in improving Qo L.
引文
1.Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
2 .Siegel RL, Miller KD, Jemal A. Cancer Statistics,2017. CA Cancer J Clin 2017;67:7-30.
3 .Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin 2016;66:115-32.
4 .Center MM, Jemal A, Lortet-Tieulent J, et al.International variation in prostate cancer incidence and mortality rates. Eur Urol 2012;61:1079-92.
5 .Kimura T. East meets West:ethnic differences in prostate cancer epidemiology between East Asians and Caucasians. Chin J Cancer 2012;31:421-9.
6 .Kheirandish P, Chinegwundoh F. Ethnic differences in prostate cancer. Br J Cancer 2011;105:481-5.
7 .Zeigler-Johnson CM, Spangler E, Jalloh M, et al.Genetic susceptibility to prostate cancer in men of African descent:implications for global disparities in incidence and outcomes. Can J Urol 2008;15:3872-82.
8 .Mottet N, Bellmunt J, Bolla M, et al. EAU-ESTROSIOG Guidelines on Prostate Cancer. Part 1:Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol 2017;71:618-29.
9 .Tefekli A, Tunc M. Future prospects in the diagnosis and management of localized prostate cancer.Scientific World Journal 2013;2013:347263.
10 .Pound CR, Partin AW, Eisenberger MA, et al.Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999;281:1591-7.
11 .Cornford P, Bellmunt J, Bolla M, et al. EAUESTRO-SIOG Guidelines on Prostate Cancer. Part II:Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer. Eur Urol2017;71:630-42.
12 .Gomella LG, Singh J, Lallas C, et al. Hormone therapy in the management of prostate cancer:evidence-based approaches. Ther Adv Urol 2010;2:171-81.
13 .Chen XQ, Huang Y, Li X, et al. Efficacy of maximal androgen blockade versus castration alone in the treatment of advanced prostate cancer:a retrospective clinical experience from a Chinese medical centre.Asian J Androl 2010;12:718-27.
14 .Fukagai T, Namiki TS, Carlile RG, et al. Comparison of the clinical outcome after hormonal therapy for prostate cancer between Japanese and Caucasian men.BJU Int 2006;97:1190-3.
15 .Chang K, Qin XJ, Zhang HL, et al. Comparison of two adjuvant hormone therapy regimens in patients with high-risk localized prostate cancer after radical prostatectomy:primary results of study CU1005.Asian J Androl 2016;18:452-5.
16 .Na Y, Ye Z, Sun G, et al. Guidelines for the diagnosis and treatment of urological diseases in China. 2014.Beijing:People’s Medical Publishing House, 2013.
17 .Franca CA, Vieira SL, Carvalho AC, et al.Relationship between two year PSA nadir and biochemical recurrence in prostate cancer patients treated with iodine-125 brachytherap. Radiol Bras2014;47:89-93.
18 .Zelefsky MJ, Shi W, Yamada Y, et al.Postradiotherapy 2-year prostate-specific antigen nadir as a predictor of long-term prostate cancer mortality. Int J Radiat Oncol Biol Phys 2009;75:1350-6.
19 .Mir MC, Li J, Klink JC, et al. Optimal definition of biochemical recurrence after radical prostatectomy depends on pathologic risk factors:identifying candidates for early salvage therapy. Eur Urol2014;66:204-10.
20 .Stephenson AJ, Kattan MW, Eastham JA, et al.Defining biochemical recurrence of prostate cancer after radical prostatectomy:a proposal for a standardized definition. J Clin Oncol 2006;24:3973-8.
21 .Kumar S, Shelley M, Harrison C, et al. Neo-adjuvant and adjuvant hormone therapy for localised and locally advanced prostate cancer. Cochrane Database Syst Rev 2006:CD006019.
22 .Lennern?s B, Edgren M, H?ggman M, et al.Postoperative radiotherapy after prostatectomy—a review. Scand J Urol Nephrol 2003;37:10-5.
23 .Han M, Partin AW, Pound CR, et al. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy.The 15-year Johns Hopkins experience. Urol Clin North Am 2001;28:555-65.
24 .Tsurumaki Sato Y, Fukuhara H, Suzuki M, et al.Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for p T3N0 prostate cancer. BMC Urol 2014;14:13.
25 .Inagaki T, Kohjimoto Y, Nishizawa S, et al. PSA at postoperative three months can predict biochemical recurrence in patients with pathological T3 prostate cancer following radical prostatectomy. Int J Urol Off J Jpn Urol Assoc 2009;16:941-6.
26 .Srougi V, Sanchez-Salas R, Secin FP, et al. The importance of surgical margins for biochemical recurrence in high-risk prostate cancer patients. J Clin Oncol 2017;35:75-75.
27 .Freedland SJ, Humphreys EB, Mangold LA, et al.Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy.JAMA 2005;294:433-9.
28 .Roberts SG, Blute ML, Bergstralh EJ, et al. PSA doubling time as a predictor of clinical progression after biochemical failure following radical prostatectomy for prostate cancer. Mayo Clin Proc2001:576-81.
29 .Bonkhoff H. Factors implicated in radiation therapy failure and radiosensitization of prostate cancer.Prostate Cancer 2012:593241.
30 .Jalloh M, Leapman MS, Cowan JE, et al. Patterns of local failure following radiation therapy for prostate cancer. J Urol 2015;194:977-82.
31 .Bubendorf L, Kolmer M, Kononen J, et al. Hormone therapy failure in human prostate cancer:analysis by complementary DNA and tissue microarrays. J Natl Cancer Inst 1999;91:1758-64.
32 .Mousses S, Wagner U, Chen Y, et al. Failure of hormone therapy in prostate cancer involves systematic restoration of androgen responsive genes and activation of rapamycin sensitive signaling.Oncogene 2001;20:6718-23.
33 .Dalela D, Santiago-Jiménez M, Yousefi K, et al.Genomic classifier augments the role of pathological features in identifying optimal candidates for adjuvant radiation therapy in patients with prostate cancer:development and internal validation of a multivariable prognostic model. J Clin Oncol 2017;35:1982-90.
34 .Suardi N, Gallina A, Lista G, et al. Impact of adjuvant radiation therapy on urinary continence recovery after radical prostatectomy. Eur Urol 2014;65:546-51.
35 .Sowerby RJ, Gani J, Yim H, et al. Long-term complications in men who have early or late radiotherapy after radical prostatectomy. Can Urol Assoc J 2014;8:253-8.
36 .Cooperberg MR, Hinotsu S, Namiki M, et al. TransPacific variation in outcomes for men treated with primary androgen-deprivation therapy(ADT)for prostate cancer. BJU Int 2016;117:102-9.
37 .Dorff TB, Flaig TW, Tangen CM, et al. Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy:SWOG S9921 study. J Clin Oncol 2011;29:2040-5.
38 .Spahn M, Briganti A, Capitanio U, et al. Outcome predictors of radical prostatectomy followed by adjuvant androgen deprivation in patients with clinical high risk prostate cancer and p T3 surgical margin positive disease. J Urol 2012;188:84-90.
39 .Mirhadi AJ, Zhang Q, Hanks GE, et al. Effect of long-term hormonal therapy(vs short-term hormonal therapy):A secondary analysis of intermediate-risk prostate cancer patients treated on NRG Oncology RTOG 9202. Int J Radiat Oncol Biol Phys 2017;97:511-5.
40 .Okubo M, Nakayama H, Itonaga T, et al. Impact of the duration of hormonal therapy following radiotherapy for localized prostate cancer. Oncol Lett2015;10:255-9.
41 .Green HJ, Pakenham KI, Headley BC, et al. Coping and health-related quality of life in men with prostate cancer randomly assigned to hormonal medication or close monitoring. Psychooncology 2002;11:401-14.
42 .Esper P, Mo F, Chodak G, et al. Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument.Urology 1997;50:920-8.
43 .Wong CK, Choi EP, Tsu JH, et al. Psychometric properties of functional assessment of cancer therapyprostate(FACT-P)in Chinese patients with prostate cancer. Qual Life Res 2015;24:2397-402.
44 .Lebret T, Davin JL, Hennequin C, et al. Selection criteria for initiation and renewal of luteinizing hormone-releasing hormone agonist therapy in patients with prostate cancer:a French prospective observational study. Ther Adv Urol 2014;6:205-14.
45 .Gandaglia G, Fossati N, Karnes RJ, et al. Use of concomitant androgen deprivation therapy in patients treated with early salvage radiotherapy for biochemical recurrence after radical prostatectomy:Long-term results from a large, multi-institutional series. Eur Urol 2018;73:512-8.
46 .Wirth MP, Weissbach L, Marx FJ, et al. Prospective randomized trial comparing flutamide as adjuvant treatment versus observation after radical prostatectomy for locally advanced, lymph nodenegative prostate cancer. Eur Urol 2004;45:267-70.
47 .Messing EM, Manola J, Sarosdy M, et al. Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N Engl J Med 1999;341:1781-8.
48 .Wu AK, Cooperberg MR, Sadetsky N, et al. Health related quality of life in patients treated with multimodal therapy for prostate cancer. J Urol2008;180:2415-22.
2 .Siegel RL, Miller KD, Jemal A. Cancer Statistics,2017. CA Cancer J Clin 2017;67:7-30.
3 .Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin 2016;66:115-32.
4 .Center MM, Jemal A, Lortet-Tieulent J, et al.International variation in prostate cancer incidence and mortality rates. Eur Urol 2012;61:1079-92.
5 .Kimura T. East meets West:ethnic differences in prostate cancer epidemiology between East Asians and Caucasians. Chin J Cancer 2012;31:421-9.
6 .Kheirandish P, Chinegwundoh F. Ethnic differences in prostate cancer. Br J Cancer 2011;105:481-5.
7 .Zeigler-Johnson CM, Spangler E, Jalloh M, et al.Genetic susceptibility to prostate cancer in men of African descent:implications for global disparities in incidence and outcomes. Can J Urol 2008;15:3872-82.
8 .Mottet N, Bellmunt J, Bolla M, et al. EAU-ESTROSIOG Guidelines on Prostate Cancer. Part 1:Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol 2017;71:618-29.
9 .Tefekli A, Tunc M. Future prospects in the diagnosis and management of localized prostate cancer.Scientific World Journal 2013;2013:347263.
10 .Pound CR, Partin AW, Eisenberger MA, et al.Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999;281:1591-7.
11 .Cornford P, Bellmunt J, Bolla M, et al. EAUESTRO-SIOG Guidelines on Prostate Cancer. Part II:Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer. Eur Urol2017;71:630-42.
12 .Gomella LG, Singh J, Lallas C, et al. Hormone therapy in the management of prostate cancer:evidence-based approaches. Ther Adv Urol 2010;2:171-81.
13 .Chen XQ, Huang Y, Li X, et al. Efficacy of maximal androgen blockade versus castration alone in the treatment of advanced prostate cancer:a retrospective clinical experience from a Chinese medical centre.Asian J Androl 2010;12:718-27.
14 .Fukagai T, Namiki TS, Carlile RG, et al. Comparison of the clinical outcome after hormonal therapy for prostate cancer between Japanese and Caucasian men.BJU Int 2006;97:1190-3.
15 .Chang K, Qin XJ, Zhang HL, et al. Comparison of two adjuvant hormone therapy regimens in patients with high-risk localized prostate cancer after radical prostatectomy:primary results of study CU1005.Asian J Androl 2016;18:452-5.
16 .Na Y, Ye Z, Sun G, et al. Guidelines for the diagnosis and treatment of urological diseases in China. 2014.Beijing:People’s Medical Publishing House, 2013.
17 .Franca CA, Vieira SL, Carvalho AC, et al.Relationship between two year PSA nadir and biochemical recurrence in prostate cancer patients treated with iodine-125 brachytherap. Radiol Bras2014;47:89-93.
18 .Zelefsky MJ, Shi W, Yamada Y, et al.Postradiotherapy 2-year prostate-specific antigen nadir as a predictor of long-term prostate cancer mortality. Int J Radiat Oncol Biol Phys 2009;75:1350-6.
19 .Mir MC, Li J, Klink JC, et al. Optimal definition of biochemical recurrence after radical prostatectomy depends on pathologic risk factors:identifying candidates for early salvage therapy. Eur Urol2014;66:204-10.
20 .Stephenson AJ, Kattan MW, Eastham JA, et al.Defining biochemical recurrence of prostate cancer after radical prostatectomy:a proposal for a standardized definition. J Clin Oncol 2006;24:3973-8.
21 .Kumar S, Shelley M, Harrison C, et al. Neo-adjuvant and adjuvant hormone therapy for localised and locally advanced prostate cancer. Cochrane Database Syst Rev 2006:CD006019.
22 .Lennern?s B, Edgren M, H?ggman M, et al.Postoperative radiotherapy after prostatectomy—a review. Scand J Urol Nephrol 2003;37:10-5.
23 .Han M, Partin AW, Pound CR, et al. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy.The 15-year Johns Hopkins experience. Urol Clin North Am 2001;28:555-65.
24 .Tsurumaki Sato Y, Fukuhara H, Suzuki M, et al.Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for p T3N0 prostate cancer. BMC Urol 2014;14:13.
25 .Inagaki T, Kohjimoto Y, Nishizawa S, et al. PSA at postoperative three months can predict biochemical recurrence in patients with pathological T3 prostate cancer following radical prostatectomy. Int J Urol Off J Jpn Urol Assoc 2009;16:941-6.
26 .Srougi V, Sanchez-Salas R, Secin FP, et al. The importance of surgical margins for biochemical recurrence in high-risk prostate cancer patients. J Clin Oncol 2017;35:75-75.
27 .Freedland SJ, Humphreys EB, Mangold LA, et al.Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy.JAMA 2005;294:433-9.
28 .Roberts SG, Blute ML, Bergstralh EJ, et al. PSA doubling time as a predictor of clinical progression after biochemical failure following radical prostatectomy for prostate cancer. Mayo Clin Proc2001:576-81.
29 .Bonkhoff H. Factors implicated in radiation therapy failure and radiosensitization of prostate cancer.Prostate Cancer 2012:593241.
30 .Jalloh M, Leapman MS, Cowan JE, et al. Patterns of local failure following radiation therapy for prostate cancer. J Urol 2015;194:977-82.
31 .Bubendorf L, Kolmer M, Kononen J, et al. Hormone therapy failure in human prostate cancer:analysis by complementary DNA and tissue microarrays. J Natl Cancer Inst 1999;91:1758-64.
32 .Mousses S, Wagner U, Chen Y, et al. Failure of hormone therapy in prostate cancer involves systematic restoration of androgen responsive genes and activation of rapamycin sensitive signaling.Oncogene 2001;20:6718-23.
33 .Dalela D, Santiago-Jiménez M, Yousefi K, et al.Genomic classifier augments the role of pathological features in identifying optimal candidates for adjuvant radiation therapy in patients with prostate cancer:development and internal validation of a multivariable prognostic model. J Clin Oncol 2017;35:1982-90.
34 .Suardi N, Gallina A, Lista G, et al. Impact of adjuvant radiation therapy on urinary continence recovery after radical prostatectomy. Eur Urol 2014;65:546-51.
35 .Sowerby RJ, Gani J, Yim H, et al. Long-term complications in men who have early or late radiotherapy after radical prostatectomy. Can Urol Assoc J 2014;8:253-8.
36 .Cooperberg MR, Hinotsu S, Namiki M, et al. TransPacific variation in outcomes for men treated with primary androgen-deprivation therapy(ADT)for prostate cancer. BJU Int 2016;117:102-9.
37 .Dorff TB, Flaig TW, Tangen CM, et al. Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy:SWOG S9921 study. J Clin Oncol 2011;29:2040-5.
38 .Spahn M, Briganti A, Capitanio U, et al. Outcome predictors of radical prostatectomy followed by adjuvant androgen deprivation in patients with clinical high risk prostate cancer and p T3 surgical margin positive disease. J Urol 2012;188:84-90.
39 .Mirhadi AJ, Zhang Q, Hanks GE, et al. Effect of long-term hormonal therapy(vs short-term hormonal therapy):A secondary analysis of intermediate-risk prostate cancer patients treated on NRG Oncology RTOG 9202. Int J Radiat Oncol Biol Phys 2017;97:511-5.
40 .Okubo M, Nakayama H, Itonaga T, et al. Impact of the duration of hormonal therapy following radiotherapy for localized prostate cancer. Oncol Lett2015;10:255-9.
41 .Green HJ, Pakenham KI, Headley BC, et al. Coping and health-related quality of life in men with prostate cancer randomly assigned to hormonal medication or close monitoring. Psychooncology 2002;11:401-14.
42 .Esper P, Mo F, Chodak G, et al. Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument.Urology 1997;50:920-8.
43 .Wong CK, Choi EP, Tsu JH, et al. Psychometric properties of functional assessment of cancer therapyprostate(FACT-P)in Chinese patients with prostate cancer. Qual Life Res 2015;24:2397-402.
44 .Lebret T, Davin JL, Hennequin C, et al. Selection criteria for initiation and renewal of luteinizing hormone-releasing hormone agonist therapy in patients with prostate cancer:a French prospective observational study. Ther Adv Urol 2014;6:205-14.
45 .Gandaglia G, Fossati N, Karnes RJ, et al. Use of concomitant androgen deprivation therapy in patients treated with early salvage radiotherapy for biochemical recurrence after radical prostatectomy:Long-term results from a large, multi-institutional series. Eur Urol 2018;73:512-8.
46 .Wirth MP, Weissbach L, Marx FJ, et al. Prospective randomized trial comparing flutamide as adjuvant treatment versus observation after radical prostatectomy for locally advanced, lymph nodenegative prostate cancer. Eur Urol 2004;45:267-70.
47 .Messing EM, Manola J, Sarosdy M, et al. Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N Engl J Med 1999;341:1781-8.
48 .Wu AK, Cooperberg MR, Sadetsky N, et al. Health related quality of life in patients treated with multimodal therapy for prostate cancer. J Urol2008;180:2415-22.