title: Orchidectomy following failure of antiandrogen monotherapy in patients with metastatic prostate cancer.
abstract: 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.
authors.affiliation: Department of Urology, Auckland Hospital, Auckland, New Zealand.
authors.forename: A
authors.initials: A
authors.lastname: Tan
authors.forename: J
authors.initials: J
authors.lastname: Tuckey
authors.forename: M
authors.initials: M
authors.lastname: Rice
mesh_terms: 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
chemical_list: D000726:Androgen Antagonists