Adverse Pathological Features Do Not Predict Benefit of Hormone Therapy in Prostate Cancer

FRIDAY, Sept. 4, 2026 (HealthDay News) — For patients with prostate cancer, adverse pathological features are prognostic, but do not modify the benefit of adding hormone therapy (HT) to postoperative radiotherapy, according to a study published online July 28 in European Urology.

Amar U. Kishan, M.D., from the University of California, Los Angeles, and colleagues obtained individual patient data from five randomized phase 3 trials of postoperative radiotherapy with or without HT to examine whether the overall survival (OS) and metastasis-free survival (MFS) benefits of adding HT would be modified by an increasing count of adverse pathological features (adverse feature count [AFC]). AFC was prospectively defined as the sum of grade group 4 to 5 disease, seminal vesicle invasion, positive surgical margins, and extracapsular extension.

Individual patient data were included from 4,781 patients, who were followed for a median of 9.1 years. The researchers found that AFC was independently prognostic for both OS and MFS. The OS or MFS benefits of HT were not significantly modified by AFC (interaction hazard ratios, 0.93 [95 percent confidence interval, 0.79 to 1.10; P = 0.4] and 0.88 [95 percent confidence interval, 0.77 to 1.01; P = 0.08], respectively). When AFC was analyzed categorically and in high-risk subsets and when a restricted AFC score was used, the results were similar.

“These findings highlight an important distinction between predicting risk and predicting treatment benefit,” Kishan said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

Abstract/Full Text (subscription or payment may be required)