Result and prognostic factors after endocrine therapy for treatment of advanced prostatic cancer

Lee, Sung Won; Moon, Woo Chul

Abstract

We analyzed 39 patients with advanced prostatic cancer to define the results and prognostic factors after endocrine therapy. Patient ages ranged from 48 to 83 years (mean 66.0). Patients received immediate endocrine therapy after diagnosis. 29 patients had systemic metastasis, of whom 28 were located in bone. 20 patients received orchiectomy, 9 diethylstilbesterol (DES), 5 both orchiectomy and DES, 3 ketoconazole, and 2 detapeptyl, respectively, Response to endocrine therapy were analyzed depending on NPCP criteria. Of 32 evaluable patients. 19 (59.4% ) showed stabilization, 9 (28.1%) partial response, and 4 progression, Mean duration of partial response and stabilization were 34.9 months and 20.1 months, respectively. Post-treatment 2 and 5 year survival rate were 83.3% (20/24) and 37.5% (6/16), respectively. Number of metastatic lesion of less than 3. Gleason score of less than 8, and Karnofsky performance index of 80 or more were significant variables to predict the better response rate (p<0.025 ) and higher 2 year survival rate (p<0.05) after endocrine therapy. Age, pretreatment duration, level of serum acid phosphatase, and degree of Leydig cell atrophy on testis histology were not significantly correlated with outcomes of endocrine therapy. In conclusion, objective response to and survival after endocrine therapy in advanced prostatic cancer is limited, and only selected group of patients with intrinsically good prognosis, show good results.