Transsphenoidal stereotaxic cryohypophysectomy for the management of pain in disseminated prostatic carcinoma.
Nineteen adult males with disseminated carcinoma of the prostate gland associated with intractable pain were subjected to a transsphenoidal stereotaxic cryohypophysectomy. Growth hormone (GH) assays following insulin-induced hypoglycemia were obtained once during the preoperative and twice during the postoperative period. In the postoperative assays, a 73% or greater suppression of GH levels correlated with significant clinical remission and extended survival. In all patients who had as much as 73% reduction in GH level, pain relief occurred within 4 days or less after surgery. This study shows that subtotal hypophysectomy may be adequate to achieve satisfactory clinical remission and pain control. GH assay is a useful index of the adequacy of hypophysectomy.
D000328:Adult; D000368:Aged; D003452:Cryosurgery; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007016:Hypophysectomy / Q000379:methods*; D008297:Male; D010148:Intractable Pain / Q000097:blood / Q000209:etiology / Q000601:surgery*; D010166:Palliative Care; D010903:Pituitary Gland, Anterior / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000150:complications / Q000601:surgery*; D013997:Time Factors
D013006:Growth Hormone