Histological effect of prolonged hormonal therapy on prostate cancer

Abstract

4708 Background: To determine the histological effect of prolonged hormonal therapy on prostate cancer, we evaluated radical prostatectomy specimen after androgen ablation therapy. Methods: From January 2001 to December 2003, 36 patients underwent retropubic radical prostatectomy after several periods of hormonal therapy. The median period of hormonal therapy was 8 months (2 to 74 months) and 5 patients were given more than 3 years. Results: Seven of 36 patients (19.4%) had no residual cancer (pT0) in radical prostatectomy specimen. Periods of hormonal treatment of these patients were 6, 7, 8, 8, 16, 40, and 44 months, respectively. In the patient who was given the hormonal treatment for 74 months, only a small amount of degenerated, but viable cancer cells remained and this tumor was considered to be insignificant. Six of 7 tumors with pT0 were cT1c. There were no significant relationship between the histological effect and PSA level at diagnosis, however PSA level of all patients with pT0, except one, decreased less than 0.1 ng/ml before radical surgery. Tumors with high Gleason’s score, those received longer duration of hormonal treatment and those treated with a combined androgen blockade had a tendency to response to hormonal treatment well. Conclusions: In patients with localized prostate cancer whose PSA level kept less than 0.1 ng/ml for more than 3 years by androgen ablation, there was no significant cancer in surgical specimen. Theses findings suggest that some patients with localized prostate cancer may be cured by prolonged hormonal therapy alone. No significant financial relationships to disclose.