Orchidectomy following failure of antiandrogen monotherapy in patients with metastatic prostate cancer.
OBJECTIVE
Patients with metastatic prostate cancer who are initially treated by oral antiandrogens and then have progressive disease may be offered surgical castration as a second-line treatment. Twenty-eight such patients were reviewed to determine the outcome in terms of secondary PSA response, symptomatic relief and disease-specific survival.


METHODS
Retrospective chart-based review of patients undergoing bilateral scrotal orchidectomy after failure of antiandrogen monotherapy.


RESULTS
Patients who had a >50% reduction in PSA at 12 weeks' postorchidectomy had significantly greater duration of PSA response and disease-specific survival. 64% of patients who had bone pain prior to orchidectomy had some relief of symptoms postoperatively. No prognostic indicators of improved survival were identified.


CONCLUSIONS
Orchidectomy as a secondary hormonal treatment following relapse on antiandrogens does produce a response in terms of PSA level and symptoms in some patients.
Tan
A
A
Department of Urology, Auckland Hospital, Auckland, New Zealand.
Tuckey
J
J
Rice
M
M
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D017211:Treatment Failure
D000726:Androgen Antagonists