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Updated: Aug 6, 2026
Murine Prostate Micro-dissection and Surgical Castration
Published on: May 11, 2016
Why phase III trials of maximal androgen blockade versus castration in M1 prostate cancer rarely show statistically
L Collette1, U E Studer, F H Schröder
1European Organization for Research and Treatment of Cancer, EORTC Data Center, Brussels, Belgium. lco@eortc.be
Background:
The meta-analysis of maximal androgen blockade (MAB) concluded that there is no survival advantage of MAB over castration alone. However, the results from the largest trials yield conflicting results.
Methods:
The design and results of three trials were examined.
Results:
Most studies were planned to detect an over-optimistic difference in survival and immature data were published. The survival curves show that statistical assumptions are not fulfilled. Excluding from the meta-analysis all trials where a negative impact of disease flare on survival could not be excluded resulted in no difference in survival between MAB and castration.
Conclusions:
Trials of MAB should be planned to detect differences of no more than 5-10% in median survival. The analyses should only be carried out on mature data and should take into account the possibility of a negative impact on survival due to disease flare if no anti-androgen has been given initially with an LH-RH agonist.
