title: Surgical castration in hormone-refractory metastatic prostate cancer patients can be an alternative for medical castration.
abstract: Background. Most patients with metastatic prostate cancer are endocrinologically treated with LHRH agonist, but finally castration-refractory and hormone-refractory cancers occur. Serum testosterone levels get low to "the castration level" by LHRH agonists but may not get low enough against castration-refractory prostate cancer. Methods. As case series, twelve patients suffering from hormone-refractory prostate cancer continuously on LHRH agonist underwent surgical castration. Additionally, one hundred and thirty-nine prostate cancer patients on LHRH agonist or surgical castration were tested for serum total testosterone levels. Results. Surgical castration caused decrease in serum PSA in one out of 12 hormone-refractory prostate cancer patients with PSA reduction rate 74%. Serum total testosterone levels were below the sensitivity threshold (0.05 ng/mL) in 40 of 89 (44.9%) medically castrated patients and 33 of 50 (66.0%) surgically castrated patients (P = .20). Conclusion. Even hormone-refractory prostate cancer patients are candidates for surgical castration because of endocrinological, oncological, and economical reasons.
authors.affiliation: Department of Urology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki 211-8510, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Zaitsu
authors.forename: Mariko
authors.initials: M
authors.lastname: Yamanoi
authors.forename: Koji
authors.initials: K
authors.lastname: Mikami
authors.forename: Yuta
authors.initials: Y
authors.lastname: Takeshima
authors.forename: Naohiko
authors.initials: N
authors.lastname: Okamoto
authors.forename: Sadao
authors.initials: S
authors.lastname: Imao
authors.forename: Akiko
authors.initials: A
authors.lastname: Tonooka
authors.forename: Takumi
authors.initials: T
authors.lastname: Takeuchi