Radical Prostatectomy and Oral Flutamide for Prostatic Cancer in Pramongkutklao Hospital

Authors

  • Sathit Ruangdilokrat Division of Urology, Department of Surgery, Pramongkutklao Hospital, Bangkok 10400, Thailand

Abstract

Serum prostate-specific antigen (PSA) was used as an outcome measure in new patients who were admitted to Urologic Division since January 1993 with prostatic cancer treated with 1) Retropubic radical prostatectomy (RRP) combined with bilateral orchidectomy, and 2) Flutamide combined with bilateral orchidectomy.

The new cases of prostatic cancer from January 1993 to January 1995, were selected into this prospective study to compare the outcome of two modalities of treatment. There were 12 patients who qualified to enter the study. Two forms of treatments were set for those new and untreated cases. There were 6 radical prostatectomies and 6 cases in oral flutamide. All cases were combined treatment with bilateral orchidectomy. Serum PSA was checked after treatment at 1 month, 3 months, and 6 months follow-up. The cost of treatment, complication and side effect of drug were included in the study.

In RRP and bilateral orchidectomy group, the mean age was 68.1 ± 4.2 yr, preoperative serum PSA was 37 ± 32.7 ng/ml. The mean age in oral Flutamide plus orchidectomy was 66.3 ± 8.8 yr and serum PSA before starting treatment was 50.1 ± 32 ng/ml. The age and pretreatment serum PSA were comparable in both groups. After the treatment in 1 and 3 months, there was significant difference of serum PSA change. The mean serum PSA in RRP group was 0.06 ng/ml in first month and 0.86 ng/ml in third month, while mean serum PSA in oral Flutamide was 11.8 ng/ml in first month and 6.9 ng/ml in third month of follow-up. At sixth month of follow up, there was reverse The mean serum PSA in both groups. serum PSA in oral Flutamide was 6.1 ng/ml while in RRP was 20 ng/ml. The RRP group had poorly differentiated cell type in 4 patients and moderately differentiated adenocarcinoma in 2 cases. There were well differentiated adenocarcinoma in 3 cases and 3 moderately differentiated adenocarcinoma in 3 patients of oral Flutamide group.

The radical prostatectomy would be maximum advantage in young age group of prostatic cancer because of significant cure rate and low cost.  Oral Flutamide would be the alternative treatment of choice in older patients.

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References

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Published

1995-12-29

How to Cite

1.
Ruangdilokrat S. Radical Prostatectomy and Oral Flutamide for Prostatic Cancer in Pramongkutklao Hospital. Thai J Surg [Internet]. 1995 Dec. 29 [cited 2022 Nov. 28];16(2):56-7. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/250211

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Original Articles