A RETROSPECTIVE CLINICAL STUDY OF RELAPSED PROSTATIC CANCER

Abstract

Retrospective clinical analysis of 84 relapsed prostatic cancers hormonally treated at Tokushima University and TEKK group is reported.
The criteria for the diagnosis of relapse were any of the following: (1) increase in acid-phosphatase level, (2) local progression, (3) appearance or progression of bone metastases, (4) appearance of new metastases (excluding bone) and (5) significant cancer-related deterioration in symptoms.
Analysis of the modes of relapse showed that, of the 84 patients, 31 (36.9%) had eleveted acid-phosphatase level and 46 (54.8%) had local progression. Thirteen of 38 patients (34.2%) had bone metastases and 37 of 46 patients (80.4%) had progression of bone metastases. Of the 84 patients, 9 (10.7%) had new metastatic lesions in other than bone and 50 (59.5%) had deteriorations in symptoms.
The mean interval between the initiaion of hormone therapy and the relapse was 24.1±15.6 months. The interval was 39.0±23.4 months for Stage A₂, 25.4±14.9 months for Stage B, 24.1±16.5 months for Stage C and 21.4±12.4 months for Stage D with a significant difference observed between Stage A₂ and Stage D. The intervals of relapsed patients with well, moderately and poorly differentiated adenocarcinoma were 25.2±16.2 months, 28.6±15.0 months and 22.6±17.3 months, respectively, with no significant difference. The intervals of relapse in patients showing elevated acid-phosphatase level before therapy, as compared to those in patients with normal levels, were significantly longer. There was no difference in intervals between the patients with and without acid-phosphatase normalization by hormone therapy.
The actuarial survival rates after relapse in the 84 patients were 55.4 per cent at one year and 11.5 per cent at 5 years.