UroToday - Dr. Schroeder discussed early vs. delayed ADT in EORTC 30846. This study accrued from 1986-1998. 234 patients with T2-3N1-3M0 were randomized to immediate vs. delayed ADT without treatment of the primary tumor . Non-inferiority of delayed ADT for survival was the endpoint. Delayed treatment was given at disease progression. The median duration of ADT treatment was 2.7 years in the delayed and 3.2 years in the immediate group.

Survival analysis was performed on 115 delayed and 119 early treatment patients. At the time of this report, 193 men have died, (82.5%) and 72% of the deaths are related to CaP. 84% and 80% of delayed and immediate patients died, respectively. Overall and cancer specific survival at a median followup of 13 years showed a 22% benefit in favor of immediate ADT, but this was not statistically significant. The median survival on immediate treatment is 7.6 years vs. 6.1 years in the delayed treatment group (non-significant). An 18 month improved QOL was noted in the delayed arm. Thus there was not apparent benefit to immediate ADT.

Presented by F. H. Schroeder at the American Society of Clinical Oncology (ASCO) - 2008 Genitourinary Cancers Symposium - A Multidisciplinary Approach - February 14-16, 2008 San Francisco, California, USA

Reported by UroToday Contributing Editor Christopher P. Evans, MD, FACS Professor & Chairman Department of Urology University of California, Davis, School of Medicine Sacramento, CA

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