Adjuvant hormonal therapy following radical prostatectomy

The benefit of adjuvant treatment after radical prostatectomy in patients with extracapsular or node-positive disease is still being evaluated. In a retrospective study of 293 patients undergoing radical prostatectomy, 86 patients received adjuvant treatment. The median follow-up time was 4.1 years (range 3 months to 16 years). Forty-five patients progressed, and 27 patients died cause specifically. Calculating the time to progression and the cause-specific survival as study endpoint, the control group showed significantly better results than the adjuvantly treated group, owing to an imbalance of pathological stage between the 2 groups. The stage-correlated analysis of stage pT3 pN0 tumors according to adjuvant therapy showed no benefit in time to progression or survival for the adjuvant-treated patients. Similar results were also found for patients with positive pelvic lymph nodes. In this group adjuvant therapy again had no impact, either on time to progression or survival. At the present time, no rationale exists to call for categorical adjuvant treatment in patients with positive lymph nodes or extracapsular disease.