A 3-year follow-up of patients with localized prostate cancer operated on with or without pre-treatment with the GnRH-agonist triptorelin.
OBJECTIVE
To examine the effect of pre-operative androgen deprivation on the progression rate of malignancy in patients operated on for localized prostate cancer.


METHODS
A total of 53 patients received no hormone therapy (group 1) and a further 38 patients (group 2) received the generic releasing-hormone agonist triptorelin during the 3 months before surgery. The patients in group 1 had T1b-T2 tumours, whereas 12 of those in group 2 had clinical stage T3 tumours. Despite this, the surgical specimens from the patients in group 2 showed a rate of cancer invasion of the surgical margins 20% lower than those from the patients in group 1. After prostatectomy, the patients were followed for 3 years by repeated analyses of prostate-specific antigen (PSA) in serum.


RESULTS
During the follow-up, the PSA level exceeded the upper threshold (0.6 ng/mL) in 16% of the patients in group 1 and in 43% of those in group 2 (P < 0.05). This difference was mainly related to the pre-treatment stage of the tumor. Some of the patients in group 1 received post-operative radiotherapy but this was not reflected in their PSA levels. Of the patients in group 1 and 2, 4% and 14% respectively (P > 0.05), developed symptoms from skeletal metastases.


CONCLUSIONS
There was no evidence that pre-operative hormone therapy slowed the progression of prostate cancer.
Hellström
M
M
Department of Urology, Danderyd Hospital, Stockholm, Sweden.
Häggman
M
M
Pedersen
K
K
Busch
C
C
Brändstedt
S
S
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging / Q000379:methods; D011182:Postoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
D018931:Antineoplastic Agents, Hormonal; D017329:Triptorelin Pamoate; D017430:Prostate-Specific Antigen