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COMPARATIVE STUDY BETWEEN ORCHIDECTOMY ALONE AND ORCHIDECTOMY WITH HORMONAL THERAPY (COMBINED ANDROGEN BLOCKADE) FOR PATIENTS WITH ADVANCED CARCINOMA OF THE PROSTATE

Firas Shakir Attar

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2010 Volume: 16 Issue: 2 Pages: 95-101
Publisher: Basrah University جامعة البصرة

Abstract

Worldwide, prostate cancer incidence and mortality vary significantly between countries andregions and are highest in African American men. In the USA, prostate cancer is the mostcommon visceral malignant neoplasm in men and the second leading cause of cancer-relateddeaths. Bilateral orchidectomy with or without hormonal therapy are the main treatment optionsfor patients with advanced prostate carcinoma.The objective of this study is to compare the efficacy of orchidectomy alone and orchidectomyplus flutamide in treating patients with advanced carcinoma of prostate.The study was conducted from June 2006 to March 2010. Thirty six patients were included inthe study. The inclusion criteria were histologically documented carcinoma prostate along withdistant metastasis (stage D2). Following orchidectomy, the patients were stratified into twogroups. Group I had patients treated with orchidectomy alone (17 patients) and Group II thosetreated with orchidectomy plus flutamide therapy (19 patients). Follow up of patients was donefor the next two years following initiation of therapy.The maximum percentage change in PSA was found in the first three months afterorchidectomy. The mean percentage change at two years, in the two groups was 65% and 62%respectively. Based on the evaluation of response, there was no significant difference inresponse rate between the two treatment groups.In conclusion, addition of antiandrogen like flutamide to orchidectomy has not given anysignificant benefit to effect the PSA changes as well the survival in advanced carcinoma ofprostate. Hence, routine use of additional antiandrogen to orchidectomy is not advisable.

Keywords

ORCHIDECTOMY