The Value of Testosterone Deprivation in Stage D1 Carcinoma of the Prostate

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Abstract
The question of whether hormonal manipulation is effective in the treatment of stage D1 carcinoma of the prostate has yet to be determined conclusively. To study this question a retrospective review was conducted of 68 patients with stage D1 disease. Of the patients 22 underwent immediate orchiectomy, 24 delayed orchiectomy and 11 exogenous antiandrogen treatment (8 immediate and 3 delayed treatment), and 11 had no androgen deprivation. The patients were placed into 2 groups consisting of those receiving immediate hormonal deprivation (30) and those having treatment at the time of bone metastasis or who are as yet untreated (38). The minimum followup was 60 months. The median interval to progression to bone metastasis was 43 months in the delayed treatment group compared to 100 months in the immediate hormonal deprivation group. This difference was statistically significant (p equals 0.0087). Likewise, the median period from diagnosis to death was 90 months in the delayed treatment group and 150 months in the immediate treatment group. This difference was not significant (p equals 0.1110). Thus, orchiectomy or adequate androgen deprivation from our data significantly prolongs the interval to bone metastasis in patients with metastatic prostate cancer limited to the pelvic lymph nodes. The apparent increased length of survival of the immediate treatment group lacks statistical confirmation.