1988 Volume 79 Issue 7 Pages 1228-1234
Seventy cases with untreated prostatic cancer aged from 54 to 90 year-old were observed from November 1981 to 1987 in our clinic. Histologic grading was performed to divide the cases into 5 patterns according to Gleason grading system and tissue DHT levels were measured in 47 of the 70 cases. The average age was 73.8 years and the follow-up period was from one to sixty-five months (mean 23 months). Sixteen cases died during the follow-up period. The relations of histologic grades, tissue DHT levels and prognoses were discussed.
The primary pattern 3 was seen in 50% of the cases followed by pattern 4 and 2. Scores were divided into 3 groups, that is, 2 to 5, 6 to 7 and 8 to 10.
Scoring 6 to 7 was most common (44.3%), followed by scores 2 to 5 and 8 to 10. The high staged cases increased as score or pattern digits increased. With regards to primary pattern and death rate, Gleason's score and death rate, or Gleason's modified category and death rate, cancer death rates increased as pattern digits, score digits, or category digits increased.
The death rates were also examined in relation to tissue DHT levels and scores. DHT levels were classified into 2 categories, over 2ng/gtw (high DHT) and below. The cancer death rate in the low DHT group was definitely higher than that of the high DHT group.
The relations of clinical responses or courses and DHT levels were examined in cases on endocrine therapy. The high DHT group showed partial objective regression (PR) in 57% of cases but there were only 21.4% of cases that showed PR in the low DHT group. Cancer deaths in the low DHT group were caused by progression of the disease. On the other hand, those in the high DHT group were caused by relapses after PR was achieved for a certain period.
Gleason grading system was useful to predict clinical stages and final prognosis. Tissue DHT levels were one of the useful indications to predict responses to endocrine therapy, but it is difficult to predict response durations or relapses.
