Impact of Androgen Deprivation Therapy on Volume Reduction and Lower Urinary Tract Symptoms in Patients with Prostate Cancer.

OBJECTIVE: To evaluate the impact of androgen deprivation therapy (ADT) on prostate volume, lower urinary tract symptoms (LUTS), and LUTS-related quality of life (QOL) in patients with prostate cancer.

METHODS: Patients with prostate cancer (PCa) were treated with goserelin and bicalutamide for 24 weeks. Changes in the total prostate volume (TPV), International Prostate Symptom Score (IPSS), and QOL score for urinary symptoms were assessed every 12 weeks. Of the 42 patients enrolled, 8 patients withdrew and 2 were excluded, so 32 patients were analyzed.

RESULTS: The median age, PSA levels, and TPV were 77.5 years, 22.0 ng/mL, and 29.5 cm3 , respectively. TPV showed a significant decrease from baseline in weeks 12 and 24, with the mean percent decreases being -37.5 ± 4.25 and -7.5 ± 3.84%, respectively. The IPSS decreased from baseline to weeks 12 and 24 (from 11.7 ± 1.6 to 9.3 ± 1.0 and 9.3 ± 1.0; P = 0.15 and 0.2, respectively). The IPSS voiding score showed a significant decrease from baseline to weeks 12 and 24 whereas the IPSS storage score did not. In patients with moderate to severe LUTS, the IPSS and the QOL score showed a significant decrease in weeks 12 and 24. In patients with mild LUTS, nocturia increased significantly from baseline and there was approximately one additional episode of nocturia at 24 weeks.

CONCLUSIONS: In this study, we observed that ADT significantly reduced TPV and improved LUTS in patients with PCa and moderate to severe LUTS, but increased nocturia in patients with mild LUTS.