The course of metastatic prostate cancer under treatment.

Aslan Demir,Levent Turkeri,Mert Ali Karadag,Ramazan Kocaaslan,Kursat Cecen

doi:10.1186/2193-1801-3-725

Aslan Demir, Levent Turkeri + Show 3 more

Open Access

https://doi.org/10.1186/2193-1801-3-725

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Journal: SpringerPlus	Publication Date: Dec 1, 2014
Citations: 13	License type: CC BY 4.0

Affiliation: Kafkas University

Abstract

The first-line management of metastatic prostate cancer is hormonal therapy. However, resistance to this treatment will emerge within an average of 24 months. Our purpose was to determine the course of metastatic prostate cancer under treatment.A total of 56 patients who were diagnosed with metastatic prostate cancer were enrolled. As initial management, 3 kinds of hormonal therapy consisting of bilateral orchiectomy (BSO) alone, BSO + anti-androgene (AA) and LH-RH + AA were applied. The patients were followed until the emergence of hormone resistance. Serum PSA levels at the time of first diagnosis, post-treatment nadir PSA levels, time to nadir PSA, time to hormonal resistance and PSA levels at hormonal resistance were assessed, retrospectively. The localization and number of metastases and the survival term from the beginning of the emergence of hormone resistance until death were investigatedNo significant differences could be established between the groups. The mean time to reach hormone refractory status was 30.3 months for the whole study group. The average term of survival was 42.7 months for the whole group. Distance metastases were found in 8 patients during follow-up.There were no statistical differences between the groups in terms of treatment modalities applied for metastatic prostate cancer. Patients with androgen independent prostate cancer demonstrated progression despite chemical or surgical castration, and had poor prognosis. Initial hormonal therapy failed after an average of 2 years in metastatic prostate cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-725) contains supplementary material, which is available to authorized users.

Highlights

Most of the prostate cancers (PCa) are, at least at the beginning, endocrine-dependent tumors
bilateral subcapsular orchiectomy (BSO) alone was performed in 12 patients (21.7%), adjunctive antiandrogen therapy was given to 18 patients
Bicalutamide, 150 mg once daily, it has been compared to medical or surgical castration in two large prospective randomized controlled trials (RCT) with identical study designs, including patients with locally advanced or metastatic PCa; the analysis found that in metastatic patients, there was an improvement in Overall survival (OS) with medical or surgical castration, the difference in median survival between the groups was only 6 weeks (Tyrrell et al 1998)

Summary

Introduction

Most of the prostate cancers (PCa) are, at least at the beginning, endocrine-dependent tumors. Hormonal therapy is still a first-choice treatment (Chen et al 2008). The first effects to hormonal treatment with medical or surgical castration are quite considerable, with rapid biochemical responses, as evaluated by declines in levels of the serum marker, prostate-specific antigen (PSA) (Di Lorenzo et al 2010; Chi et al 2009). Most patients showing a first response to hormonal therapy for PCa will progress to a castration-insensitive phase of the disease that continues a much poorer prognosis (Chi et al 2009). The true is that androgens have an important role in the whole clinical course of Pca, even when a patient meets castration-resistance criteria (Pinto 2013).

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