[The German HTA report: orchiectomy versus LH-RH analogues in the treatment of advanced prostate carcinoma: are there any consequences for the daily health service?].
OBJECTIVE
This systematic review evaluates international data on the medical effectiveness of orchiectomy and medical therapy with LH-RH analogues in patients with advanced prostate cancer. These results are discussed in the context of primary, neoadjuvant, adjuvant and intermittent hormone deprivation.


METHODS
A systematic, diversified literature analysis in the common medical and HTA databases and further media was conducted.


RESULTS
All identified, randomised and controlled studies concerning the application of LH-RH analogues showed the same medical effectiveness for orchiectomy and for treatment with LH-RH analogues. Four different studies regarding the quality of life revealed no significant difference between the treatment with LH-RH analogues and the therapy with orchiectomy.


CONCLUSIONS
According to available studies, there is clear evidence for the equivalent effectiveness of LH-RH analogues and orchiectomy in the treatment of advanced prostate cancer. A change back to orchiectomy - even though it is more cost-efficient - cannot be recommended when taking the extended indications for temporary hormone deprivation into consideration.
Rohde
V
V
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Marburg und Giessen, Standort Giessen, Giessen. vrohde@gmx.de
Grabein
K
K
Weidner
W
W
Wasem
J
J
Hessel
F
F
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018849:Controlled Clinical Trials as Topic; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009919:Orchiectomy; D017410:Practice Guidelines as Topic; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone