COMPARATIVE STUDY BETWEEN ORCHIDECTOMY ALONE AND ORCHIDECTOMY WITH HORMONAL THERAPY (COMBINED ANDROGEN BLOCKADE) FOR PATIENTS WITH ADVANCED CARCINOMA OF THE PROSTATE

Abstract

Worldwide, prostate cancer incidence and mortality vary significantly between countries and regions and are highest in African American men. In the USA, prostate cancer is the most common visceral malignant neoplasm in men and the second leading cause of cancer-related deaths. Bilateral orchidectomy with or without hormonal therapy are the main treatment options for patients with advanced prostate carcinoma. The objective of this study is to compare the efficacy of orchidectomy alone and orchidectomy plus flutamide in treating patients with advanced carcinoma of prostate. The study was conducted from June 2006 to March 2010. Thirty six patients were included in the study. The inclusion criteria were histologically documented carcinoma prostate along with distant metastasis (stage D2). Following orchidectomy, the patients were stratified into two groups. Group I had patients treated with orchidectomy alone (17 patients) and Group II those treated with orchidectomy plus flutamide therapy (19 patients). Follow up of patients was done for the next two years following initiation of therapy. The maximum percentage change in PSA was found in the first three months after orchidectomy. The mean percentage change at two years, in the two groups was 65% and 62% respectively. Based on the evaluation of response, there was no significant difference in response rate between the two treatment groups. In conclusion, addition of antiandrogen like flutamide to orchidectomy has not given any significant benefit to effect the PSA changes as well the survival in advanced carcinoma of prostate. Hence, routine use of additional antiandrogen to orchidectomy is not advisable.

Keywords

• orchidectomy