The treatment of advanced prostatic carcinoma with total androgenic blockade using bilateral orchidectomy and flutamide: experience at the National Cancer Institute in Mexico.

: This prospective trial was undertaken to determine the benefits of the combination of bilateral orchidectomy with flutamide, both in terms of survival and quality of life for patients with advanced prostatic carcinoma. All patients were previously untreated and received 750 mg/d of flutamide immediately after bilateral orchidectomy. The mean age was 68.9 +/- 9.4 years. Pain disappeared or decreased in 83% of patients at 3 months, 62% of patients at 6 months, and 25% of patients at 12 months. The survival was 62% at 12 months and 58% at 24 months. No patients discontinued treatment with flutamide as a result of side effects. In conclusion, total androgenic blockade with flutamide and bilateral orchidectomy was seen to be a safe and effective approach that increases survival and improves the quality of life of patients with advanced prostatic carcinoma. A greater number of patients and a larger follow-up is necessary to substantiate the improvement in survival.