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Unlike with other major epithelial cancers (breast, colon, lung), for which the role of adjuvant systemic therapy has long been established, virtually no evidence exists that adjuvant hormonal or chemotherapy leads to improvement in patient outcomes after surgery, with the possible exception of node-positive patients (N Engl J Med 1999; 341:1781).
To test the effectiveness of adjuvant hormonal or chemohormonal therapy after radical prostatectomy, investigators conducted a phase III trial involving 983 men with high-risk prostate cancer, defined as Gleason score ≥8; preoperative prostate-specific antigen (PSA) level ≥15 ng/mL; stage T3b, T4, or N1disease; or Gleason score of 7 with either preoperative PSA >10 ng/mL or a positive margin. Patie…