COMPARISON OF SUBCAPSULAR AND TOTAL ORCHIECTOMY FOR TREATMENT OF METASTATIC PROSTATE-CANCER

Objectives. To determine whether subcapsular orchiectomy provides subo ptimal treatment of metastatic prostate cancer when used to avoid the psychologic consequences of the empty scrotum that results from total orchiectomy. Methods. We compared testosterone and prostate-specific a ntigen levels and survival of 37 patients who underwent total orchiect omy and 37 patients who underwent subcapsular orchiectomy for metastat ic prostate cancer. Results. The two groups of 57 patients were simila r by clinical parameters. Postoperatively, testosterone levels were 21 +/- 11 ng/dL for subcapsular versus 21 +/- 9 ng/dL for total orchiect omy patients, Tumor response was similar in the two groups when assess ed by prostate-specific antigen measured 3 weeks, 6 months, and 1, 2, and 3 years postoperatively, Survival was similar when assessed using Kaplan-Meier analysis (P = 0.76). Conclusions, Subcapsular orchiectomy is a viable option for treatment of metastatic prostate cancer.