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become an established treatment for certain patients with prostate carcinoma. W. Holt Sanders, M.D. LHRH-a are known to decrease bone mineral density. The purpose of this study Robert O. Northway, M.D. was to determine the risk of bone fracture in men receiving LHRH-a for prostate a for the treatment of prostate carcinoma. Abstracted data included the number Georgia. of monthly LHRH-a injections, age, clinical stage of disease, sites of metastases, and bone fracture history. RESULTS. Twenty of the 224 patients (9%) treated with LHRH-a for prostate carci-noma between 1988 and 1995 at 3 teaching hospitals had at least 1 bone fracture during treatment with LHRH-a. The duration of treatment to the time of fracture ranged from 1 to 96 months (mean, 22.2 months). Seven fractures (32%) were osteoporotic in nature (i.e., vertebral compression fractures or hip fractures after a fall from standing), whereas 8 fractures (36%) were associated with a significant traumatic event (i.e., a motor vehicle accident, boxing, etc.) and 5 were of mixed etiology. Two of 22 fractures (9%) were pathologic. CONCLUSIONS. This study demonstrated a 9% fracture incidence in a cohort of patients receiving LHRH-a for prostate carcinoma for up to 96 months. The incidence of osteoporotic fractures was 5%.

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Objectives To better define the relationship between platelet count and survival using a retrospective analysis in patients with thrombocytosis and metastatic renal cell carcinoma (RCC), some of whom had a shorter life expectancy than those with a normal platelet count. Patients and methods The records were reviewed of patients with stage IV RCC who had undergone a variety of adjuvant therapies after nephrectomy between 1972 and 1992. Entry criteria included a tissue diagnosis of RCC, at least one platelet count and a complete follow‐up until the time of death. Of 350 patients available for review, 259 met the entry criteria. Patients were divided into two groups: group 1 included 112 patients whose platelet counts remained at < 4 × 105/µL between the time of nephrectomy and the time of death; group 2 included 147 patients with at least one platelet count of > 4 × 105/µL (mean age in each group 57 years). Results The mean ( sd) survival for group 1 was 151 (34) months, compared with 92 (18) months for those in group 2. Using the log‐rank chi‐square test the difference in survival between the groups was significant (P = 0.005). Controlling for established prognostic indicators of pathological stage, nuclear grade and cell type, using Cox's regression technique, the difference in survival between the groups remained significant (P = 0.015). Conclusions These results suggest that patients with metastatic RCC who receive adjuvant therapy and have a persistently normal platelet count have a 64% longer life expectancy than those with thrombocytosis. The difference is highly statistically significant when controlled for nuclear grade, cell type and pathological stage.