The effect of neoadjuvant androgen suppression on prostate cancer-related outcomes after high-intensity focused ultrasound therapy.

Abstract

To explore the effect of neoadjuvant androgen suppression (AS) compared to no AS on cancer-related outcomes after radical high-intensity focused ultrasound (HIFU) therapy for men with presumed organ-confined prostate cancer. Between January 1999 and January 2005, 250 patients underwent HIFU for presumed localized adenocarcinoma of the prostate; 154 had received neoadjuvant hormonal therapy and 96 had not. The primary outcome measure was treatment failure, as defined by the presence of prostate cancer on the biopsy taken 6 months after HIFU. Multiple logistic regression was used to examine relationships between the use of HIFU with and with no neoadjuvant AS and treatment failure. The treatment failure rate was slightly lower in patients receiving neoadjuvant AS (31% vs 34%), but this was not statistically significant (P = 0.119). In this unrandomized comparison between neoadjuvant or no AS before HIFU for men with presumed organ-confined prostate cancer, there appeared to be little if any benefit associated with the previous administration of AS.