RESULTS OF THE TREATMENT OF PROSTATIC CANCER

Abstract

Ninety-five patients with prostatic carcinoma first treated from 1963 to 1972 were followed through 1975. Age of the patients ranged from 45 to 85 years old with an average of 68 years old. Histological diagnosis was adenocarcinoma in all patients; 64 patients had well differentiated type and 31 had poorly differentiated type. Five patients were classified in stage T₀N_xM₀, one in stage T_1-2NxMo, 45 in stage T_3-4N_xM₀, and 44 in stae T_0-4N_xM₁. All patients were treated by synthetic estrogen (hexestrol). Castration was done in combination with estrogen therapy in 74 patients.
Patients with non-metastatic prostatic carcinoma showed a little better relative survival rates than patients with metastatic prostatic carcinoma; 5-year relative survival rates were 55% (S. E. 10%) for non-metastatic prostatic carcinoma and 35% (S. E. 10%) for metastatic prostatic carcinoma.
Survival rates of patients with prostatic carcinoma of poorly differentiated type were significantly worse than those of well differentiated type; 5-year relative survival rates were 10% (S. E. 7%) for poorly differentiated type and 65% (S. E. 9%) for well differentiated type.
As for the dosis of synthetic estrogen, 41 patients were maintained on 100mg of hexestrol daily and 54 patients on 30mg daily. There was no significant difference of the relative survival rates between the two groups.
Relative survival rates of patients who had castration in combination with estrogen therapy were not superior to those of patients with estrogen therapy only.
The effect of anti-androgenic therapy on the size of palpable prostatic mass was estimated. The size had been reduced in 25% of patients, unchanged in 36% and increased in 36%. The results were not related to the grade or stage of the carcinoma.
X-ray examination showed that metastasis deteriorated in 70% of patients who had metastasis at first seen and metastasis newly developed in 40% of patients.
Patients who had hydronephrosis due to prostatic carcinoma survived very poorly; 5-year relative survival rate was 8% (S. E. 8%).
Patients with elevated serum alkaline phosphatase revealed a little worse survival rates than those with normal levels.
Elevation of serum acid phosphatase, accelerated erythrocyte sedimentation rates or anemia found at first seen had no significant influences on the relative survival rates.
Side effects of anti-androgenic therapy were as reported by many investigators. Causes of death were mostly due to the carcinoma.