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Therapeutics
Anti-androgen treatment immediately after surgery for prostate cancer improved survival

https://doi.org/10.1136/ebm.5.4.105

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    (1999) N Engl J Med 341, 1781. 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.. Dec 9;. :. –8.
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 QUESTION: In men with node positive prostate cancer, is survival prolonged by starting anti-androgen treatment immediately after surgery rather than delaying it until the appearance of disease progression?

    Design

    Randomised {allocation concealed*}†, unblinded,* controlled trial with median 7.1 years follow up.

    Setting

    6 US university centres.

    Patients

    98 men (median age 66 y) who had clinically localised prostate cancer (≤ stage T2), had had radical prostatectomy and bilateral pelvic lymphadenectomy within the previous 12 weeks, and had histologically confirmed nodal metastases.

    Intervention

    Patients were allocated to anti-androgen treatment with either goserelin, 3.6 mg subcutaneously every 28 days, or bilateral orchiectomy (n=47) or to be followed until evidence existed of disease progression other than newly detectable or rising levels of prostate specific …

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    Footnotes

    • Sources of funding: National Institutes of Health and Department of Health and Human Services.

    • For correspondence: Dr E M Messing, University of Rochester, Department of Urology, 601 Elmwood Avenue, Box 656, Rochester, NY 14642, USA. Fax +1 716 442 8350.

    • ↵* See glossary.

    • ↵† Information provided by author.