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Early Dutasteride Monotherapy in Patients With Elevated Serum Prostate-Specific Antigen Levels Following Robot-Assisted Radical Prostatectomy
- Source :
- Frontiers in Oncology, Frontiers in Oncology, Vol 9 (2019)
- Publication Year :
- 2019
-
Abstract
- Background: To evaluate the efficacy of early dutasteride administration in patients with a detectable prostate-specific antigen (PSA) levels after robot-assisted radical prostatectomy (RARP).Methods: We retrospectively analyzed RARP patients whose pathological stage is T2a to T3b without lymph node or distant metastasis from 2007 to 2017. All patients received a daily dose of 0.5 mg of dutasteride when post-RARP PSA levels were increasing but had not achieved biochemical recurrence. PSA levels were monitored every 3 months after dutasteride administration. None of the patients received radiotherapy (RT) or androgen-deprivation therapy (ADT) before taking dutasteride. All follow-ups were begun from RARP to January 2019 or to the date of RT/ADT.Results: Thirty-five patients were included in this analysis. The median followed up was 53.6 months. Twenty-two patients (62.9%) showed a PSA response in which the PSA decreased more than 10% at the first follow-up after dutasteride administration. The Pathological stage > T2 (p = 0.012) and positive surgical margin (p = 0.046) were prognostic factors for a PSA response. Twenty-three out of 35 included patients (65.7%) did not require further RT/ADT. The significant risk factor was the PSA level (p = 0.011) at the beginning of dutasteride treatment. The cut-off value of the PSA level to avoid further RT/ADT was 0.195 ng/ml.Conclusions: Early dutasteride administration showed a significant decline in the PSA levels of patients with pathology stage >T2 and positive surgical margin in our retrospective hypothesis-generating study. If dutasteride was provided before the PSA value increased to 0.195 ng/ml after RARP, it would reduce the probability of acquirement of RT/ADT.
- Subjects :
- 0301 basic medicine
Biochemical recurrence
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Urology
robotic assistance for radical prostatectomy
prostate specific antigen
urologic and male genital diseases
lcsh:RC254-282
03 medical and health sciences
chemistry.chemical_compound
Prostate cancer
0302 clinical medicine
medicine
Stage (cooking)
Lymph node
biochemical recurrence (BCR)
Original Research
dutasteride
Prostatectomy
business.industry
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Dutasteride
medicine.disease
prostate cancer
Radiation therapy
Prostate-specific antigen
030104 developmental biology
medicine.anatomical_structure
chemistry
Oncology
030220 oncology & carcinogenesis
business
Subjects
Details
- ISSN :
- 2234943X
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Frontiers in oncology
- Accession number :
- edsair.doi.dedup.....560418b9a4cbae3f399e548213670a82