DECREASE OF PROSTATIC INTRAEPITHELIAL NEOPLASIA FOLLOWING ANDROGEN DEPRIVATION THERAPY IN PATIENTS WITH STAGE-T3 CARCINOMA TREATED BY RADICAL PROSTATECTOMY

Objectives. Prostatic intraepithelial neoplasia (PIN) is considered th e most likely precursor of prostatic adenocarcinoma. The effect of and rogen deprivation therapy on the prevalence of PIN is unknown. Methods . We undertook a case-control study of radical retropubic prostatectom ies from 24 treated patients and a control group of 24 untreated patie nts matched for age and clinical stage (all T3). Androgen deprivation therapy included LHRH agonist leuprolide and flutamide (18 patients), diethylstilbesterol (DES) (2 patients), DES with leuprolide and flutam ide (1 patient), and orchiectomy (3 patients). Prostatectomy specimens were evaluated for the presence and extent of high-grade PIN accordin g to the number of high-power microscopic fields, and nuclear tumor gr ade (1 to 4 scale) and Gleason score were also determined. Results. Th e prevalence of high-grade PIN in pretreatment transrectal needle biop sies was similar in the treated and untreated groups. The prevalence a nd extent of high-grade PIN were lower in cases treated with androgen deprivation therapy than controls. Nuclear tumor grade was also lower in treated patients, but there was a paradoxical increase in the Gleas on score. The prevalence of aneuploidy in the cancers was similar in b oth groups. Conclusions. These findings suggest that androgen deprivat ion therapy decreases the prevalence and extent of high-grade PIN.