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What duration of androgen deprivation therapy do you use for patients with pN+ prostate cancer undergoing upfront adjuvant RT after a radical prostatectomy and pelvic lymph node dissection?
Do other factors (i.e. Gleason score, pretreatment PSA, or pT stage) affect your decision?
Answer from: Radiation Oncologist at Academic Institution
As @Mitchell S. Anscher mentioned, the Messing randomized trial (ECOG 3886) showed that lifelong ADT (vs. observation) improved overall survival in patients with pN+ prostate cancer after radical prostatectomy. This trial provides the only level 1 evidence for this patient population. Therefore...
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Answer from: Radiation Oncologist at Academic Institution
Based on the Messing study, I recommend lifetime androgen deprivation, regardless of other factors. This study showed an overall survival advantage for lifetime ADT.