Torres GA, Bustamante RF, Alias MA

Language: Spanish
References: 15
Page: 153-159
PDF size: 230.12 Kb.

ABSTRACT

Hormone suppression is the standard treatment for metastatic prostate cancer. In some solid tumors, treating the original tumor helps there to be a better response to systemic therapy. A total of 21 carefully selected patients presenting with prostate cancer and bone metastases, who along with conventional hormone suppression, underwent radical prostatectomy, were analyzed and compared with 60 patients presenting with bone metastases with characteristics similar to those of the operated patients, but who were treated only with hormonal blockade.
Time free from tumor progression and overall survival rate were better in the group having undergone both radical prostatectomy and hormone suppression compared with the group receiving only hormone suppression (62.3% vs 44.8% and 76.2% vs 56.2%, respectively). There was also a lower incidence of local morbidity due to tumor growth in the radical prostatectomy group. Prospective, comparative and random studies should be carried out to evaluate the role radical surgery plays in patients with metastases due to prostate cancer.

REFERENCES

1. Registro Histopatológico de Neoplasias en México. S.S.A. 2001.

2. Crawford ED. Management of newly-diagnosed metastatic prostate cancer. In Prostate Cancer 2nd International Consultation on Prostate Cancer, Edited by G Murphy. S Khoury, A Partin, L Denis1999:351.

3. Hellerstedt BA, Pienta KJ. The current state of hormonal therapy for prostate cancer. CA Cancer J Clin 2002;52:154-159.

4. The National Institute of Health Consensus Development Conference: Adjuvant Therapy for Breast Cancer. Bethesda, MD: November 1-3, 2000. J Natl Cancer Inst Monogr 2001;30:1-152.

5. Gunderson LL, Sargent DJ, Tepper JE et al. Impact of T and N stage and treatment on survival and relapse in rectal cancer: a pooled analysis. J Clin Oncol 2004;22:1785-1796.

6. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC et al. Nephrectomy followed by interferon alfa2b compared with interferon alfa-2b alone for metastatic renal cell cancer. N Engl J Med 2001;345:1655-1659.

7. Palapattu GS, Allaf M E, Trock BJ et al. Prostate specific antigen progression in men with lymph node metastases following radical prostatectomy: results of long-term follow-up. J Urol 2004;172:1860-1864.

8. Frohmuller HG, Theiss M, Manseck A, Wirth MP. Survival and quality of life of patients with stage D1 (T1-3 pN1-2 M0) prostate cancer: radical prostatectomy plus androgen deprivation versus androgen deprivation alone. Eur Urol 1995;27:202-206.

9. Steinberg GD, Epstein JI, Piantadosi S, Walsh PC. Management of stage D1 adenocarcinoma of the prostate: the Johns Hopkins experience 1974 to 1987. J Urol 1990;144:1425-1432.

10. Ghavamian R, Bergstralh EJ, Blute MI et al. Radical retropubic prostatectomy plus orchiectomy verus orchiectomy alone for pTxN+ prostatec cancer: a matched comparison. J Urol 1999;161:1223-1228.

11. Seay TM, Blute MI, Zincke H. Long-term outcome in patients with pTxN+ adenocarcinoma of prostate treated with radical prostatectomy and early androgen ablation. J Urol 1998;159:357-364.

12. Thompson I M, Tangen C, Blaster J, and Crawford AC. Impact of previous local treatment for prostate cancer on subsequent metastatic disease. J Urol 2002;168:1008-1012.

13. Roach M 3rd, DeSilvio M, Lawton C et al. Phase-III trial comparing whole-pelvic versus prostate-only radiotherapy and neoadjuvante versus adjuvant combined androgen suppression: Radiation Therapy Oncololgy Group 9413. J Clin Oncol 2003;21:1904-1911.

14. Zagars GK, Pollack A, von Eschenbach AC. Addition of radiation therapy to androgen ablation improves outcome for subclinically node-positive prostate cancer. Urology 2001;58:233-239.

15. Swanson GP, Riggs M, Earle J. Failure after primary radiation or surgery for prostate cancer: differences in response to androgen ablation. J Urol 2004;172:525-528.