Prostatic Adenocarcinoma: A Review of 65 Cases

Choo, Myung Soo; Lee, Chongwook

Abstract

Herein we analyze retrospectively 65 patients with prostatic adenocarcinoma managed at Seoul National University Hospital during a 9 year period from January 1975 to January 1984. Major presentations are prostatism (60%), bone pain and urinary retention. Thirteen patients were diagnosed as B.P H. initially and in 18 patients, hard nodules were palpable by rectal examination. Hydronephrotic changes were found on I.V.P in 15 patients and the causes of those were identified in 4 patients by cystoscopy and, or CT scan. There were direct invasion by the primary tumor in 2 patients and metastasis to pelvic lymph nodes in 2 patients. Perineal needle biopsy was performed in 38 patients and adenocarcinoma was confirmed in 35 patients. In 42 patients, distant metastases were found by various diagnostic procedures including bone survey, bone scan and CT scan. According to the VAUORG staging system, 65 patients were classified as stage A (8), stage B (5) stage C (3) and stage D (49). In 49 stage D patients, endocrine therapy was done in 42 patients and 17 patients of them underwent additional T.U.R. of prostate. Only 26 patients were followed properly. Three patients with stage A survived more than 2 years and 9 patients with stage D died within 2 years while 14 patients with stage D survived more than 2 years. The causes of death in 9 stage D patients were wide spread metastasis in 6 and uncertain in 3 patients. Two year survival rate of the stage D patients was 60% (14/ 23) and the mean survival time of the dead within 2 years was 16.1 months. 35 of 65 patients had elevated level of serum acid phosphates prior to therapy, which fell to less than 50% of initial value or to normal within 1 month after endocrine therapy in 9 of 12 patients.