Prostatic Carcinoma Cured with Hormonal Treatment

Johansson, Sonny L.; Ljunggren, E

doi:10.3109/00365598109179628

Cited by 12 publications

(1 citation statement)

References 3 publications

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“…Finally, downstaging to PTo has been reported after endocrine treatment by several authors but rather as an anecdotal event [34][35][36][37][38], In our series also in 1 patient, the pathologist could not find any tumor in the surgical specimen after serial sectioning.…”

Section: Resultsmentioning

confidence: 51%

Neoadjuvant Hormonal Deprivation before Radical Prostatectomy

Sassine

Schulman

1993

Eur Urol

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Section: Resultsmentioning

confidence: 51%

Neoadjuvant Hormonal Deprivation before Radical Prostatectomy

Sassine

Schulman

1993

Eur Urol

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Factors affecting bone mineral density in patients with prostate carcinoma before and after orchidectomy

Agarwal

Khandelwal

Mandal

et al. 2005

Cancer

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BACKGROUNDOrchidectomy is an accepted form of androgen‐deprivation therapy (ADT) for prostate carcinoma. Osteoporosis is common in elderly individuals and is accelerated by ADT. The authors studied changes in bone mineral density (BMD) after ADT and factors that affected those changes.METHODSFifty patients with prostatic adenocarcinoma who opted to undergo orchidectomy were studied prospectively. All patients completed 6 months of follow‐up, and 20 of those patients completed 12 months of follow‐up. Patients' age, weight, height, body mass index (BMI), physical activity, addiction (smoking, alcohol), dietary calcium intake, and lactose tolerance status were noted. Lumbar spinal (L1–L3) trabecular BMD was measured with quantitative computed tomography (QCT) at baseline and every 6 months for 1 year and was compared with preoperative values. The effects of various patient characteristics on preoperative BMD and changes in BMD also were analyzed.RESULTSThe mean ± standard deviation (SD) age of the patients was 69.5 ± 8.1 years, BMI was 23.5 ± 3.9 kg/m2, dietary calcium intake was 1066.1 ± 443.3 mg per day. Thirty‐eight percent of patients were lactose intolerant. Sixty‐two percent of patients were in the light weight‐bearing activity group. The mean ± SD preoperative BMD was 119.2 ± 34.9 mg/cc, with T‐scores of − 1.77 ± 1.22 and Z‐scores of 0.43 ± 1.27. A decrease in BMD during the first 6 months (≈ 13%) was statistically significant (P = 0.0001) and continued further during next 6 months (BMD loss of ≈ 18% at 12 months). Patients with osteoporosis, as defined by T‐scores ≤ − 2.5, increased from 24% at baseline to 48% at 6 months. Nonsmokers, nonalcoholics, patients with higher physical activity, and patients with a BMI > 25 kg/m2 had statistically significant higher BMD compared with their counterparts (P < 0.05). Body weight < 60 kg and BMI < 25 kg/m2 were significant risk factors for loss of BMD (P < 0.05). Dietary calcium had a discernible but statistically insignificant effect on BMD (P = 0.16). Lactose intolerance had no significant effect on BMD or bone loss.CONCLUSIONSOsteoporosis was common in the population affected by prostate carcinoma. Orchidectomy led to accelerated bone loss. Periodic measurement of BMD after ADT would help in the early detection of osteoporosis. Maintenance of high BMI, weight‐bearing physical activity, avoidance of alcohol and smoking, and possibly high dietary calcium intake help in maintaining bone mass. Cancer 2005. © 2005 American Cancer Society.

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Neoadjuvant androgen blockade prior to prostatectomy: A retrospective study and critical review

Schulman

1994

Prostate

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The treatment of locally advanced prostatic cancer is controversial, as there are several possible treatment options. The aims of temporary androgen deprivation prior to radical prostatectomy are to achieve downgrading and downstaging of the tumor, an increase in local control, a decrease in morbidity and operative sequelae, a decrease in the time to progression, and an improvement in survival.A retrospective study has been carried out on 100 patients who underwent radical prostatectomy between 1988 and 1992. Forty patients received androgen deprivation therapy followed by prostatectomy, while the remaining 60 acted as controls, undergoing prostatectomy alone. Treated patients had a 40-50% reduction in prostate volume after 3 months, facilitating dissection of the prostate, reducing intraoperative blood loss, and reducing operation time. Of these 40 treated patients, one third showed clinical downstaging; one patient staged initially as T 2 B was downstaged to PTO.The proportion of patients with positive surgical margins was 32% in the group treated preoperatively, compared with 57% in untreated patients. Treated patients also recovered full continence more rapidly after the operation than patients who underwent prostatectomy alone.After androgen blockade, serum PSA levels returned to normal (<4 ng/ml) in 37 of the 40 patients. Of these patients, 22 had undetectable serum PSA levels (<0.25 ngiml), showing a definite reduction in tumor activity. PSA levels after 3 months of neoadjuvant hormonal treatment might play a useful predictive role in selecting patients before radical prostatectomy, since 86% with undetectable PSA had tumors confined to the gland (T2/B2), while patients who still had PSA > 4 ng/ml all had stage T3-T4 tumors.Although downstaging was confirmed pathologically in only 13% of patients, this is of significance when the total number of patients with locally advanced prostate cancer is considered and, therefore, may have implications for survival in the future. Prospective randomized studies should provide conclusive information on the potential benefit of this approach.

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Prostatic Carcinoma Cured with Hormonal Treatment

Cited by 12 publications

References 3 publications

Neoadjuvant Hormonal Deprivation before Radical Prostatectomy

Neoadjuvant Hormonal Deprivation before Radical Prostatectomy

Factors affecting bone mineral density in patients with prostate carcinoma before and after orchidectomy

Neoadjuvant androgen blockade prior to prostatectomy: A retrospective study and critical review

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