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Selected Publication:
PUMMER, K; CRAWFORD, ED; DANESHGARI, F; ANDROS, B; PFISTER, S; MILLER, GJ.
HORMONAL PRETREATMENT DOES NOT AFFECT THE FINAL PATHOLOGICAL STAGE IN LOCALLY ADVANCED PROSTATE-CANCER
UROLOGY. 1994; 44(6A): 38-42.
Doi: 10.1016/S0090-4295(94)80242-4
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- Leading authors Med Uni Graz
- Pummer Karl
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- Abstract:
- Objective. To determine the effect of hormonal deprivation on final pathologic stage in locally advanced prostate cancer. Methods. We studied 34 patients with clinical stage B2 or C prostate cancer who underwent androgen deprivation therapy before radical prostatectomy at the University of Colorado Health Sciences Center. Staging was primarily based on digital rectal examination, transrectal ultrasound (TRUS), radionucleotide bone scan, computed tomography (CT scan) of the pelvis, transrectal coil magnetic resonance imaging (MRI), and measurement of serum prostate-specific antigen (PSA). The majority of patients underwent laparoscopic lymph node dissection and 5 patients with positive nodes were excluded. Five patients were treated with oral flutamide (250 mg three times daily), the other patients received a combination of the depot luteinizing hormone-releasing hormone analog leuprolide (7.5 mg) and flutamide (250 mg three times daily). Treatment duration was 4 months. PSA measurement was repeated every 4 weeks and TRUS as well as endorectal MRI was repeated prior to surgery. Results. Although serum PSA levels dropped significantly by 98% from a mean of 37.4 to 0.9 ng/mL (mean +/- SD), volume reduction of 50% occurred, and histopathologic changes as an effect of androgen deprivation could be observed in all patients; all but 1 patient had pathologic stage C disease. Conclusion. We conclude that the value, if any, of such an approach is limited regarding the final pathologic stage. However, since 14 of 18 patients had an undetectable serum PSA after a mean follow-up of 15 months, the long-term effect of this concept warrants further study.
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