Impact of Androgen Deprivation Therapy on Lower Urinary Tract Symptoms in Patients with Prostate Cancer

TL;DR

This study shows that androgen deprivation therapy improves urinary symptoms in prostate cancer patients, especially those with severe symptoms or older age.

Contribution

The study identifies specific factors influencing the improvement of urinary symptoms during androgen deprivation therapy in prostate cancer patients.

Findings

ADT significantly reduced prostate size and improved urinary flow and symptoms over 24 weeks.

Patients with moderate-to-severe baseline symptoms showed the greatest improvement in symptom scores.

Age and PSA levels were significantly associated with changes in urinary flow rates.

Abstract

Background and Objectives: The increasing number of patients with prostate cancer receiving long-term androgen deprivation therapy (ADT) underscores the importance of maintaining quality of life during treatment. Lower urinary tract symptoms (LUTS), influenced by prostate size, represent significant determinants of quality of life in this population. This study aimed to investigate the impact of ADT on LUTS in patients with prostate cancer, particularly focusing on how ADT, which reduces prostate volume (PV), affects quality of life, and to identify factors influencing changes in LUTS. Materials and Methods: The study included 104 patients with prostate cancer undergoing ADT. Changes in the International Prostate Symptom Score (IPSS), PV, maximal uroflow rate (Qmax), post-void residual urine volume (RU), and prostate-specific antigen (PSA) levels were compared before treatment initiation and at 12 and 24 weeks after treatment. Association between these variables and patient age, body mass index (BMI), Gleason score (GS), and T stage were also assessed. Results: After 12 and 24 weeks of ADT, prostate size decreased by 16.69 cm3 (32.03%) and 25.36 cm3 (48.68%), respectively, with PSA levels decreasing by 7.63 ng/mL and 22.03 ng/mL. Qmax improved by 3.19 mL/s and 5.57 mL/s, and RU decreased by 42.31 mL and 60.68 mL, respectively (p < 0.001). The IPSS decreased by 13.09 and 14.69 points at 12 and 24 weeks, respectively (p < 0.001). Notably, patients with moderate-to-severe LUTS (baseline IPSS ≥ 8) showed a significantly greater reduction in IPSS (p < 0.001). Additionally, patient age and PSA levels were significantly associated with changes in Qmax (p < 0.001). Conclusions: ADT demonstrated a positive effect on LUTS improvement in patients with prostate cancer, particularly among those with moderate-to-severe LUTS, elevated PSA levels, or older age.

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