Effectiveness of 5-Alpha-Reductase Inhibitors in Patients With Prostatic Intraepithelial Neoplasia of Peripheral Prostate Zone

Abstract

Prostate intraepithelial neoplasia (PIN) is a widespread pathologic state, which in 16-25 % cases leads to prostate cancer (PC). Today specific operative and medicated methods of PIN treatment are not developed. The aim of PIN treatment represents at the same time cancer prevention. 5-alpha-reductase inhibitor Dutasteride is routinely used in benign prostate hyperplasia treatment. In last decade a lot of investigations are directed to study role of different medical supplies in PC prevention. Previous investigations had controversial results due to different approaches and patients number. The article is about use of 5-alpha-reductase inhibitor Dutasteride in patients with PIN of peripheral prostate zone. Purpose. To determine role of 5-alpha-reductase inhibitor Dutasteride in patients with PIN of peripheral prostate zone. Materials and methods. The results of examination of 93 patients with PIN were assessed. According to the aim of the study all patients were divided into two groups: dynamic follow-up (1 group, n = 57) and dutasteride (2 group, n = 36). Dutasteride was used 0.5 mg a day within 1 year. Follow-up period lasted 3 years. Transrectal prostate biopsies guided by ultrasound were performed every 6 months. Discussion. There was a difference in PC detection rate between two groups of patients. Among patients with peripheral zone PIN 29 prostate cancer cases were determined, that was 31.2 % of all patients. In the 1 group without treatment the frequency of PC counted 42.1 % including 8.3 % of PC in IV stage and 12.5 % of PC in III stage. In the 2 group with Dutasteride treatment the rate of PC was 13.9 % and no cases of PC in IV stage were detected during 3 year follow-up. This is an evidence of high clinical value of 5-alpha-reductase inhibitor Dutasteride in patients with PIN of peripheral prostate zone. Further study is required to stratify all PIN patients into groups of high malignisation risk in order to perform detailed examination and treatment.