Carcinoma of the Prostate: A Continuing Co-Operative Study

Mellinger, George T.; Arduino, Lino J.; Becker, Leslie E.; Berman, Henry I.; Bischoff, Arthur J.; Doe, Richard P.; Elliot, James S.; Gehan, Edmund A.; Glucksman, Michel A.; Gross, Alan J.; Haltiwanger, Earl; Higgins, Robert; Jorgens, Joseph; Kaplan, Ervin; Kramer, Howard C.; Lee, Lyndon E.; Lilien, Otto M.; Malament, Maxwell; Mostofi, F. K.; Nataro, Maurice; Parry, William L.; Ulm, Aaron Hardy

doi:10.1016/s0022-5347(17)64178-8

Cited by 34 publications

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“…The administration of estrogenic substances can not only decrease the size of prostatic cancer significantly, but also the size of canine prostatic tumors (153). Although Scott (154) concluded that total prostatectomy plus combined endocrine therapy (estrogen treatment and orchiectomy) was the method of choice for the treatment of patients with either advanced prostatic carcinoma or nodular lesions presumably confined within the capsule, the Veterans Administration Cooperative Urologic Research Group (155) found that the effect of combined orchiectomy‐estrogen therapy for carcinoma of the prostate was not appreciably better than that of estrogen administration alone. Robson (40) reported a striking decrease of prostatic carcinoma among patients with severe cirrhosis (and presumably more secondary hyperestrinism) than among patients with less severe cirrhosis.…”

Section: Prostatic Carcinoma—possible Prophylaxismentioning

confidence: 99%

Estrogenic Management of Benign Prostatism, Including Early and Poor‐risk Cases: 7‐year Experience*

Roberts

1966

J American Geriatrics Society

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Section: Prostatic Carcinoma—possible Prophylaxismentioning

confidence: 99%

Estrogenic Management of Benign Prostatism, Including Early and Poor‐risk Cases: 7‐year Experience*

Roberts

1966

J American Geriatrics Society

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Carcinoma of the prostate: Prognostic evaluation of certain pathologic features in 208 radical prostatectomies

Byar

Mostofi

1972

Cancer

407

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In a study of 208 total prostates removed surgically for early carcinoma of the prostate and studied by the step-section technique, we found that 97% were located either peripherally or both peripherally and centrally; 80% were bilateral, and 85% were multifocal. In most of the cases, the tumor was actually more extensive than detected by rectal examination, but there was reasonable agreement (74.5%) between the urologist and pathologist in assessing the presence of local extension of carcinoma. Evaluation of various factors affecting survival and mortality disclosed that an extension of the tumor to seminal vesicles or invasion of the capsule, whether detected clinically or pathologically, had an unfavorable prognosis while the side involved, the location of the tumor, and perineural invasion had no significant effect on the prognosis. NUMBER OF PREVIOUS PATHOLOGIC STUDIESevaluate the findings in relation to survival. A A of carcinoma of the prostate based on number of total prostatectomy specimens obthe technique of step-sections are avail-tained through the VA Cooperative Urological able,6s9J2 but these have been retrospective Research Group afforded us an unusual o p studies confined to the prostate gland removed portunity to evaluate certain pathologic findat autopsy rather than surgical total prosta-ings in relation to survival and mortality. It tectomy specimens and, in none of these is our purpose here to report these findings. studies, has there been the opportunity to

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The veterans administration cooperative urological research group's studies of cancer of the prostate

Byar

1973

Cancer

566

181

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The results of these clinical trials over the past 12 years have revealed an unsuspected toxicity of DES used in treating patients with cancer of the prostate when given in a dose of 5.0 mg daily. The first VA study did not show that orchiectomy was superior to estrogen in treating cancer of the prostate or that the combination orchiectomy plus estrogen had much to offer beyond the benefits of estrogen alone when indicated. The preponderance of evidence from the second study shows that 1.0 mg of DES appears to be about as effective as the 5.0 mg dose in treating cancer of the prostate but does not carry the excess hazard of cardiovascular deaths. Our overall recommendation at present is that patients with prostatic cancer should not be treated until their symptoms require relief, and at that time we recommend starting treatment with 1.0 mg DES daily. These recommendations may change as we continue to analyze our data.

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Carcinoma of the Prostate: A Continuing Co-Operative Study

Cited by 34 publications

References 0 publications

Estrogenic Management of Benign Prostatism, Including Early and Poor‐risk Cases: 7‐year Experience*

Estrogenic Management of Benign Prostatism, Including Early and Poor‐risk Cases: 7‐year Experience*

Carcinoma of the prostate: Prognostic evaluation of certain pathologic features in 208 radical prostatectomies

The veterans administration cooperative urological research group's studies of cancer of the prostate

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