Androgen deprivation therapy prevents bladder cancer recurrence.

// Koji Izumi 1 , Masataka Taguri 2 , Hiroshi Miyamoto 3 , Yoshinori Hara 4 , Takeshi Kishida 5 , Kimio Chiba 6 , Tetsuo Murai 7 , Kotaro Hirai 8 , Kotaro Suzuki 9 , Kiyoshi Fujinami 10 , Teiichiro Ueki 11 , Koichi Udagawa 12 , Kazuo Kitami 13 , Masatoshi Moriyama 14 , Yasuhide Miyoshi 15 , Futoshi Tsuchiya 16 , Ichiro Ikeda 17 , Kazuki Kobayashi 18 , Maho Sato 2 , Satoshi Morita 19 , Kazumi Noguchi 15 , Hiroji Uemura 1 1 Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan 2 Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan 3 Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA 4 Department of Urology, Odawara Municipal Hospital, Odawara, Japan 5 Department of Urology, Kanagawa Cancer Center, Yokohama, Japan 6 Department of Urology, Kawasaki Municipal Ida Hospital, Kawasaki, Japan 7 Department of Urology, International Goodwill Hospital, Yokohama, Japan 8 Department of Urology, Sagamihara National Hospital, Sagamihara, Japan 9 Department of Urology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan 10 Department of Urology, Chigasaki Municipal Hospital, Chigasaki, Japan 11 Department of Urology, Japanese Red Cross Hadano Hospital, Hadano, Japan 12 Department of Urology, Hiratsuka Kyousai Hospital, Hiratsuka, Japan 13 Department of Urology, Fujisawa City Hospital, Fujisawa, Japan 14 Department of Urology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan 15 Department of Urology, Yokohama City University Medical Center, Yokohama, Japan 16 Department of Urology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan 17 Department of Urology, Yokohama Minami Kyousai Hospital, Yokohama, Japan 18 Department of Urology, Yokosuka Kyousai Hospital, Yokosuka, Japan 19 Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan Correspondence to: Hiroji Uemura, e-mail: hu0428@med.yokohama-cu.ac.jp Keywords: Bladder cancer, recurrence, androgen, androgen deprivation therapy Received: November 05, 2014      Accepted: December 03, 2014      Published: December 24, 2014 ABSTRACT Although accumulating preclinical evidence indicates the involvement of androgen receptor signals in bladder cancer (BC) development, its clinical relevance remains unclear. We aimed to evaluate the predictive role of androgen deprivation therapy (ADT) in BC recurrence in prostate cancer (PC) patients. We retrospectively reviewed 20,328 patients with PC diagnosed during 1991–2013 and identified 239 (1.2%) men having primary BC. After excluding ineligible patients, 162 patients made up a final cohort. With a median follow-up of 62 months, 38 (50%) of 76 control patients without ADT experienced BC recurrence, while 19 (22%) of 86 did in ADT group. Thus, patients having received ADT for their PC showed a significantly lower risk of BC recurrence (5-year actuarial recurrence-free survival: 76% v 40%; P < 0.001) and also had a significantly smaller number of recurrence episodes (5-year cumulative recurrence: 0.44 v 1.54; P < 0.001), compared to the control patients. A multivariable analysis revealed ADT as an independent prognosticator (hazard ratio, 0.29; 95% confidence interval, 0.17–0.49) for BC recurrence. This is the first clinical study showing that ADT significantly reduces the risk of BC recurrence.