The Effect of Short-term Dutasteride Intake in Early-stage Prostate Cancer: Analysis of 148 Patients Who Underwent Three-dimensional Prostate Mapping Biopsy

OBJECTIVES The effect of dutasteride on existing prostate cancer volume is largely unknown. In this study, we assessed the impact of dutasteride on tumor burden and Gleason score. METHODS A retrospective review of patients from our institution was performed, examining men interested in surveillance for prostate cancer, who underwent transperineal three-dimensional mapping (TP-3DM) biopsy within 3-6 months after their initial cancer diagnosis. The criteria to qualify for TP-3DM biopsy included prostate-specific antigen <10 ng/mL, Gleason score <= 7, <= 2 positive cores out of 12. There were 2 cohorts of men-those who took dutasteride daily before the TP-3DM biopsy and those who did not receive any 5ARIs. Upstaging of prostate cancer diagnosis was defined as an increase in one or more positive cores or a change from unilateral to bilateral disease. RESULTS From 2006-2008, a cohort of 148 men underwent TP-3DM biopsy of the prostate. Ninety-one men received a treatment regime of dutasteride at least 3 months before TP-3DM biopsy. Fifty-seven men did not receive dutasteride or any other 5ARI. Approximately 74% of men who did not take dutasteride were upstaged and/or upgraded compared with 49.4% of men who received dutasteride (P = .0038). CONCLUSIONS We observed a 24.3% decrease in the proportion of upstaging and/or upgrading of prostate cancer in men who received dutasteride at least 3 months before 3D prostate TP-3DM biopsy. Thus, the effect of dutasteride on prostate cancer may have implications for its potential use as a secondary chemoprevention agent. UROLOGY 76: 1067-1071, 2010. (C) 2010 Elsevier Inc.