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The use of androgen deprivation therapy (ADT) as primary treatment for patients with clinically localized prostate cancer has increased significantly during the past decade, perhaps because clinicians have extrapolated from results showing ADT’s benefit in combination with radiotherapy for patients with positive nodes after prostatectomy or with locally advanced disease (JW Oncol Hematol Jun 17 2008). However, ADT also has been associated with increased risk for osteoporotic fractures, new-onset diabetes, coronary heart disease, and sudden cardiac death (JW Oncol Hematol Oct 11 2006). Given the lack of prospective evidence supporting ADT monotherapy for management of localized prostate cancer, investigators from an academic center in New Je…