Document Detail

Bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for stage C or D1 adenocarcinoma of the prostate: possible beneficial effect of adjuvant treatment.
MedLine Citation:
PMID:  3173496     Owner:  NLM     Status:  MEDLINE    
Limited clinical stage C (T3 NX M0) disease can be treated surgically, and morbidity can be acceptable. When appropriate adjuvant therapy (orchiectomy and/or radiation) is administered, residual cancer can be controlled locally for at least a limited period. The incidence of local progression in pathologic stage C or D1 disease may be negligible after early adjuvant orchiectomy and/or radiation treatment. The combination of immediate orchiectomy and radical prostatectomy has been shown to limit progression significantly (P = .0009) in many patients with D1 (T0-3 N1,2 M0) disease. However, some patients do not respond to this combination treatment, which suggests that systemic dissemination of heterogeneous tumor cells is unresponsive to adjuvant androgen ablation therapy. The DNA ploidy pattern may be a valuable predictor of disease outcome after treatment in stage D1 disease. Other pathologic variables (including acid phosphatase levels) have not been useful in predicting disease outcome or treatment response. Finally, patients with limited clinical stage C disease and those with pathologic C or D1 disease should be enrolled in a prospective randomized protocol so that the possible beneficial effects of adjuvant treatment programs can be evaluated. Apart from the usual pathologic variables and prostate-specific antigen testing, the DNA pattern should be included as a stratification factor.
H Zincke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  NCI monographs : a publication of the National Cancer Institute     Volume:  -     ISSN:  0893-2751     ISO Abbreviation:  NCI Monogr     Publication Date:  1988  
Date Detail:
Created Date:  1988-11-03     Completed Date:  1988-11-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8610384     Medline TA:  NCI Monogr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  109-15     Citation Subset:  IM    
Department of Urology, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Acid Phosphatase / analysis
Adenocarcinoma / mortality,  surgery*,  therapy
Combined Modality Therapy
Follow-Up Studies
Lymph Node Excision*
Middle Aged
Prostatic Neoplasms / mortality,  surgery*,  therapy
Reg. No./Substance:
EC Phosphatase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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