[Predictive value of the serum PSA level in patients having undergone neo-adjuvant hormone treatment before radical prostatectomy].
Great interest has been generated recently in preoperative androgen deprivation for clinical stage B ou C (T2 ou T3) prostate cancer. The influence of neoadjuvant hormonal therapy on down-staging and down-grading is still controversial. To assess the influence of preoperative androgen deprivation on serum PSA levels, we compared pre- and post-treatment serum PSA levels in 54 patients who received complete pre-operative androgen blockade (LHRH agonist + flutamide) 3 months prior to surgery. All patients with a pretreatment PSA > 20 ng/ml had extra-prostatic disease excepted two patients who presented lesions of acute prostatitis with adenocarcinoma. After hormonal deprivation, 51/54 patients experienced a return of PSA to normal values (< 4 ng/ml). Among this patient, 33 had undetectable PSA levels (< 0.25 ng/ml). 90% of the patients with undetectable had tumor confined to the gland (pT2/B). On the other hand, patients who still have PSA > 4 ng/ml after hormonal deprivation, had extra-prostatic cancer (pT3-pT4). Thus, PSA levels after 3 months neo-adjuvant hormonal treatment might have a useful predictive value in patients selection for radical surgery.
Wildschutz
T
T
Service d'urologie, Hôpital Erasme, Cliniques universitaires de Bruxelles.
Janssen
T
T
Schulman
C
C
D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery; D000726:Androgen Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000302:isolation & purification*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery
D000726:Androgen Antagonists; D017430:Prostate-Specific Antigen