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Preoperative Endocrine Therapy for Clinical Stage A 2 , B, and C Prostate Cancer: An Interim Report on Short‐Term Effects
Author(s) -
Homma Yukio,
Akaza Hideyuki,
Okada Kiyoki,
Yokoyama Masao,
Moriyama Nobuo,
Usami Michiyuki,
Hirao Yoshihiko,
Tsushima Tomoyasu,
Sakamoto Atsuhiko,
Ohashi Yasuo,
Aso Yoshio
Publication year - 1997
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1997.tb00161.x
Subject(s) - medicine , prostate cancer , prostatectomy , urology , stage (stratigraphy) , lymph node , endocrine system , dissection (medical) , biochemical recurrence , prostate , prostate specific antigen , cancer , surgery , hormone , paleontology , biology
Background Preoperative endocrine therapy has been suggested to improve surgical radicality and/or patient prognosis in prostate cancer. Methods Patients with clinical stage A 2 , B, and C prostate cancer were randomized to either group I (n = 113) or group II (n = 111). Croup I patients were to receive preoperative endocrine therapy consisting of leuprolide and chlormadinone for 3 months, followed by radical prostatectomy with lymph node dissection. Group II patients were to undergo the surgery before endocrine therapy. Results: Group I patients showed a remarkable decrease in prostate‐specific antigen (PSA) (mean ± SE: 41.8 ± 8.6ng/mL to 2.7 ± 0.7 ng/mt) and prostate volume (29.8 ± 1.7 mL to 21.2 ± 1.6 mL) during the preoperative therapy. Histopathologic analysis showed a significant difference in the rates of down‐staging (19.1 % in group I versus 3.3% in group II), positive surgical margins (63.8% versus 81.3%) and positive lymph node metastasis (20.7% versus 36.5%). No significant difference was detected in operating features. Subgroup analyses indicated that beneficial effects were correlated positively with degree of histologic differentiation and negatively with the basal PSA level. Conclusions Preoperative endocrine therapy reduced local extention of prostate cancer, and the effects depended on histologic differentiation and PSA level. Long‐term follow‐up data are needed to determine the effects on the patient prognosis.