Androgen deprivation therapy for clinically localized prostate cancer

Yoichi Arai, Koji Mitsuzuka

Research output: Chapter in Book/Report/Conference proceedingChapter


Androgen deprivation therapy (ADT) has been widely used as primary monotherapy in men with localized prostate cancer (PCa). Since most new cases of PCa are diagnosed in the early stages in the prostate-specific antigen (PSA) era, the situation has gradually changed toward earlier and longer use of hormone therapy. Emerging evidence suggests the potential harm associated with long-term use of ADT, such as increased risks of osteoporosis, cardiovascular disease, and metabolic change. It is important to understand the impact of primary ADT (PADT) on survival among men who do not undergo definitive treatment. Large, population-based studies suggest that PADT does not improve survival in men with localized PCa, and there are data suggesting reduced overall survival with ADT. Many of the randomized, controlled trials (RCTs) of immediate versus deferred ADT failed to show a survival benefit of immediate use of ADT for localized PCa. In the most recent RCT, immediate ADT resulted in a modest but statistically significant increase in overall survival, but no significant difference in PCa mortality or symptom-free survival. A subset of men with localized PCa may benefit from immediate PADT, but this must be weighed against the adverse effects of long-term ADT.

Original languageEnglish
Title of host publicationHormone Therapy and Castration Resistance of Prostate Cancer
PublisherSpringer Singapore
Number of pages11
ISBN (Electronic)9789811070136
ISBN (Print)9789811070129
Publication statusPublished - 2018 May 11


  • Androgen deprivation therapy
  • Localized
  • Primary
  • Prostate cancer

ASJC Scopus subject areas

  • Medicine(all)


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