Prognosis of patients with T4 prostate carcinoma

Background: The clinical course of patients with T4 prostate carcinoma was examined in order to consider whether there are alternative treatment optio ns besides androgen ablation therapy. Methods: From 1986 to 1995 at Chiba University Hospital, there were 22 case s of T4 prostate carcinoma. Sixteen cases had no bone metastasis at initial diagnosis. Tumor grade and response of prostate-specific antigen (PSA) to endocrine treatment were evaluated in these 16 cases. Results: Four patients had moderately differentiated and 12 had poorly diff erentiated adenocarcinoma. For initial treatment, all patients received end ocrine therapy. Anti-androgen therapy was effective in 15 cases and the 5 y ear cause-specific and progression-free survival rates were 72.1 and 38.1%, respectively. Patients with moderately differentiated tumors tended to hav e a longer disease-free period than those with poorly differentiated tumors (P=0.047). Conclusions: Endocrine therapy was effective in patients with T4 tumors. It was suggested that aggressive local treatment (i.e. radiotherapy) in combi nation with endocrine therapy may be considered if the patients had no dist ant metastases and had a long life expectancy.