HORMONE RESISTANT AND HORMONALLY ESCAPED PROSTATIC CANCER
Time Decision of Therapeutic Alteration Basedon Grading Reevaluation by Repeat Needle Biopsy
1986 Volume 77 Issue 3 Pages 489-494
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1986 Volume 77 Issue 3 Pages 489-494
To clearize the limitation and the refractory mechanism during endocrine therapy for prostatic cancer patient, retrospective correlative analysis of histological grading with prognosis were studied. The pathological spacimens were reviewed by Gleason's grading system on repeatedly biopsied and TUR materials in consecutively followed sixty nine patients initially consulted in 1974-1980.
1) By Gleason's predominant pattern, actural five-year survival rate was 55.6% for pattern I, II., 56.5% for pattern III, 32.7% for pattern IV, and 27.7% for pattern V, in needle biopsied spacimens before treatment.
2) Histological comparison between initial biopsied and re-biopsied or TUR-P spacimen during endocrine therapy showed grade up in eleven of thirty-five (31.4%) in stage C and fourteen of thirty-eight (36.8%) in stage D cases. In addition, no grade change was revealed in fourteen of thirth-five (40%) of stage C and twenty-two of thirty-eight (357.8%) in stage D.
3) In refractory and/or dead cases of initially clinical stage B to D patients, 25 of 60 cases (41.6%) revealed grade-up. In addition, 24 of 54 cases (44.4%) of stage C and D patients including five cases of Gleason score 10 was found no change of grading figure.
Getting together, in our study, consideration of tumor grade by Gleason system provided a more accurate prediction of prognosis. These results corroborate that re-evaluation of histological grade by repeat biopsy during endocrine therapy for prostatic cancer patient is more helpful to make determination of the therapeutic alteration positively.
