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  • Title: [Effect of complete androgen block before radical prostatectomy for cancer of the prostate].
    Author: Gómez Veiga F, Lorenzo Patiño MJ, Díaz Bermúdez J, Duarte Novo J, Alvarez Castelo L, Chantada Abal V, Sánchez Rodríguez J, González Martín M.
    Journal: Arch Esp Urol; 1997 May; 50(4):355-63. PubMed ID: 9313044.
    Abstract:
    OBJECTIVE: To evaluate the efficacy of complete androgen deprivation in downstaging advanced localized prostate cancer prior to radical prostatectomy. The study evaluated positive margins, prostate volume, PSA and histological changes. METHODS: We evaluated 22 patients with stage T2 (13 pts, 59%) and T3 (13 pts, 59%) prostate cancer treated with complete androgen deprivation for at least 3 months prior to radical prostatectomy. RESULTS: PSA levels dropped in 97% (51.1-1.4 ng/dl) after treatment (p < 0.001); 20 (90%) had PSA < 3 ng/dl, including 3 cases (14%) with positive nodes; 2 cases (9%) with pT2 tumor had PSA > 3 ng/ml. The mean prostate volume dropped 33% from 52.6 to 35.2 cc (p < 0.001). Of the 22 cases, only one T2 (4%) was staged down; 10 (45.5%) had positive margins versus 17 (53%) of the control group (p > 0.05). The Gleason score increased in 19 (86%) and 90% had cytoplasmic vacuolization and pyknosis with moderate nuclear lysis in 50%. CONCLUSION: Neoadjuvant treatment significantly reduces PSA levels and prostate volume. The decrease in PSA levels, however, does not appear to have a direct correlation with the final pathologic stage. Tumor stage changed slightly in patients with T2 tumors and no response was observed in those with T3. Patients receiving neoadjuvant therapy had a slight advantage with respect to positive margins. The histological findings were suggestive of cellular lysis.
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