Clinical significance of the local response to prostatic carcinoma during hormonotherapy

: The main goal of hormonotherapy in management of locally advanced or metastatic prostate cancer is the control over the progression of the neoplastic disease rather than a possible benefit to the primary lesion. Nevertheless during hormonal treatment an evident decrease of prostatic volume can often be noted even though its clinical meaning has rarely been investigated. In order to evaluate a possible correlation between local modifications and prognosis, a retrospective analysis of a group of patients on hormonotherapy was performed. From March 1987 to March 1991, 98 patients with clinical stage C and D2 prostate cancer were treated. Fifty two of them were considered eligible for assessing local response because they had had neither surgery nor radiotherapy over the prostate; moreover their pre-treatment prostatic volume, as assessed by US scan, exceeded 22 ml. Out of these patients 24 were given Goserelin every 4 weeks and the remaining 28 added Flutamide at the dose of 750 mg per day. The prostatic volume was assessed quarterly and considered as response if decreased more than 35% of pretreatment value or as progression if increased over 25% of immediately previous value. In both cases the result needed to be confirmed three months later, but it was registered when first observed. After a mean follow-up of 32.4 +/- 18.7 months a local response occurred in 44 patients (84.6%) during a period ranging 3 to 18 months. Eight patients did not show a prostatic volume decrease and 4 suffered of local progression. In these latter cases the local progression coincided with distant progression.(ABSTRACT TRUNCATED AT 250 WORDS)