| Autor: |
Travis, Harrison, Dubic, Michael, Bardot, Joseph, Edwards, Blane, Gills, Jessie R., Delacroix Jr, Scott E., LaCour, Stephen, Mutter, Matthew, Bell, Donald, Westerman, Mary E. |
| Předmět: |
|
| Zdroj: |
Ochsner Journal; Sep2024, Vol. 24 Issue 3, p171-178, 8p |
| Abstrakt: |
Background: Androgen deprivation therapy, themainstay of treatment for patients with advanced prostate cancer, can be either medical or surgical. Surgery has cost beneits compared to medical treatment. In this study, we evaluated the use of simple and epididymal-sparing orchiectomy in 2 diferent practice settings for the treatment of metastatic prostate cancer. Methods: We reviewed patients who underwent surgical castration for metastatic prostate cancer between 2011 and 2022. The primary outcome was achieving castration-level total testosterone of<50 ng/dL.We also compared the characteristics of patients who were seen at a public academic teaching hospital vs those who were seen at a private community hospital (oncology group practice), andwe evaluated the impact of orchiectomy approach (simple vs epididymal-sparing orchiectomy) on patient outcomes. Results:We analyzed 101 patients who underwent orchiectomy: 40 (39.6%) at a public academic teaching hospital and 61 (60.4%) at a private community hospital (oncology group practice). Of these patients, 81 (80.2%) underwent simple orchiectomy and 20 (19.8%) underwent epididymal-sparing orchiectomy. Forty-nine patients (48.5%) had previously receivedmedical androgen deprivation therapy, 9 (18.4%) of whom had medication adherence issues. Patient age, race, and marital status difered signiicantly between hospital facilities. The overall surgical complication rate was 3.0%. Postoperative total testosterone levels were available for 81 patients, drawn amedian of 57 days after surgery [IQR 30, 123]. All patients had castrate-level total testosterone (median 10 ng/dL [IQR 9, 19]) postoperatively, with no diferences seen between surgery location (P = 0.84) or surgical technique (P = 0.90). Conclusion: Simple or epididymal-sparing orchiectomy is safe and efective for surgical castration and is an alternative tomedical androgen deprivation therapy for patients diagnosed with metastatic prostate cancer regardless of the practice demographics. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
