Downstaging of stage C prostatic carcinoma by inductive chemo-hormonal therapy?
One hundred and three patients with clinical stage C prostatic carcinoma (palpable extra-organ extension) underwent inductive chemo-hormonal treatment followed by radical retropubic prostatectomy with pelvic lymphadenectomy. First a careful noninvasive tumor staging was performed, which included a thorough digital rectal palpation, PSA, PAP, chest X-ray, bone scan, IVP, transabdominal and transrectal ultrasonography, CT and MRI. Then inductive chemo-hormonal therapy commenced. It consisted of total androgen deprivation plus the administration of cDDP or 5-FU + calcium folinate + mitomycin. After completion of chemotherapy (i.e. 4 months later), noninvasive staging was repeated. Then radical prostatectomy was carried out, followed by histologic work-up of the specimen. Postinductive, noninvasive examinations showed clinical downstaging in 49 of the original 103 patients (47.5%). Histopathology showed confinement of the tumor to the prostate in 40 specimens (38.8%). These results prove that chemo-hormonal induction is highly effective and suggest strongly but do not prove definitely histological downstaging in a significant percentage of the patients.
Köllermann
M W
MW
Department of Urology, Municipal Hospital, Wiesbaden, FRG.
Sprenk
P
P
Mühlfait
V
V
Kahla
H
H
Köllermann
J
J
D000726:Androgen Antagonists / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002369:Castration; D003131:Combined Modality Therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*
D000726:Androgen Antagonists