Traditionally, there has been some question about the survival benefit of early androgen ablation instituted prior to the appearance of systemic metastases versus late androgen ablation upon the appearance of symptomatic metastases. However, more recent data4 suggests that in the presence of pathologically documented nodal metastases, immediate institution of hormonal therapy may improve long-term survival.
- Androgen ablation therapy with orchiectomy or LHRH agonists.
4. Messing EM, Manola J, Sarosdy M, et al. Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N Engl J Med 1999;341:1781-8.
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