Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?
| Autor: | Mohamed Adel Atta, Mohamed Elsaqa, Mohamed Sharafeldeen, Ahmed Elabbady, Wael Sameh |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Urology 030232 urology & nephrology Bilateral orchidectomy Androgen deprivation therapy 03 medical and health sciences Prostate cancer chemistry.chemical_compound 0302 clinical medicine medicine Degarelix 030219 obstetrics & reproductive medicine bilateral orchidectomy business.industry Gold standard Antagonist medicine.disease humanities LHRH antagonist health-related quality of life chemistry Lhrh antagonist business hormones hormone substitutes and hormone antagonists Oncology/Reconstruction Hormone |
| Zdroj: | Arab Journal of Urology |
| ISSN: | 2090-598X |
| Popis: | Objective: To compare bilateral orchidectomy, as the classical ‘gold standard’ androgen-deprivation therapy (ADT), and ADT using a luteinising hormone-releasing hormone (LHRH) antagonist (degarelix) for the treatment of metastatic prostate cancer regarding their short-term biochemical efficacy, testosterone castrate level, tolerability, and effect on health-related quality of life (HRQoL). Patients and methods: A total of 60 patients with newly diagnosed metastatic prostate cancer were managed by either bilateral orchidectomy or degarelix injection as ADT. Both groups were compared according to their prostate-specific antigen (PSA) nadir and testosterone level at the 6-month follow-up. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) after 12 months. Results: Bilateral orchidectomy and degarelix showed comparable results for PSA reduction, but there was a statistically significantly lower castrate level of testosterone in the bilateral orchidectomy group. Using the EROTC QLQC-30, bilateral orchidectomy was associated with better HRQoL, better global health status, and better functional status. Conclusion: Bilateral orchidectomy resulted in lower castrate levels of testosterone, which may be associated with better disease control, together with better HRQoL and general health status compared to LHRH antagonist (degarelix). These results indicate that we should consider revisiting bilateral orchidectomy as a valuable and effective treatment option for ADT. Abbreviations: ADT: androgen-deprivation therapy; EORTC (QLQ-C30): European Organisation for Research and Treatment of Cancer (Quality of Life Questionnaire-Core 30); HRQoL: health-related quality of life |
| Databáze: | OpenAIRE |
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