ANTIANDROGEN THERAPY FOR CARCINOMA OF THE PROSTATE

Abstract

One hundred and five patients with prostatic cancer were treated at Department of Urology, Branch Hospital, the University of Tokyo from 1963 through 1985. Clinical stages at the first visit were A in 23 cases, B in 1, C in 33 and D in 48. The stage A group was composed of 10 of A1 and 13 of A2 patients. Since the stage B patient was only one, stage B was included in stage C in evaluation. All stage C and D patients except 2 received castration and/or estrogens as an initial therapy. Seven cases of stage A cancer (A1: 1, A2: 6) underwent the antiandrogen therapy. The remaining 16 patients with stage A (A1: 9, A2: 7) were followed without treatment. Actuarial 5-year survival rates were 68% in stage A (89% in A1 and 54% in A2), 69% in stage C and 36% in stage D. A significant difference in 5-year survival was found between stage A1 and A2, stage C and D, and stage A and D, respectively, Twenty-one patients with stage A2, C or D cancer relapsed during the hormonal treatment. Secondary therapy with radiation and/or chemotherapy (CDDP or estramustine) was performed in 12. Nine of them died of prostatic cancer within 2 years. Of 69 patients who died in this series the proportion of deaths due to prostatic cancer was 0% in the stage A1 group, 22% in the stage A2, 33% in stage C and 51% in the stage D. The rate of deaths by cardiovascular diseases was 10% in all the dead patients. In conclusion, antiandrogen therapy for prostatic cancer was favorable and cardiovascular mortality was relatively low. However, the prognosis of hormone-refractory cancer was poor and the result of combined anticancer chemotherapy was still disappointing.