Orchidectomy following failure of antiandrogen monotherapy in patients with metastatic prostate cancer

Objective: Patients with metastatic prostate cancer who are initially treat ed by oral antiandrogens and then have progressive disease may be offered s urgical castration as a second-line treatment. Twenty-eight such patients w ere reviewed to determine the outcome in terms of secondary PSA response, s ymptomatic relief and disease-specific survival. Materials and Methods: Retrospective chart-based review of patients undergo ing bilateral scrotal orchidectomy after failure of antiandrogen monotherap y. Results: Patients who had a > 50% reduction in PSA at 12 weeks' postorchide ctomy had significantly greater duration of PSA response and disease-specif ic survival. 64% of patients who had bone pain prior to orchidectomy had so me relief of symptoms postoperatively. No prognostic indicators of improved survival were identified. Conclusion: Orchidectomy as a secondary hormonal treatment following relaps e on antiandrogens does produce a response in terms of PSA level and sympto ms in some patients. Copyright (C) 2001 S. Karger AG, Basel.