Advanced prostatic carcinoma. Early versus late endocrine therapy

Urol Clin North Am. 1991 Feb;18(1):15-24.

Abstract

Since the landmark observations of Huggins and Hodges in 1941, androgen deprivation has been the mainstay of treatment for advanced-stage prostate cancer. Although early, poorly controlled studies suggested enhanced survival with hormonal therapy, this view fell into disfavor as a result of the observations of the first and second VACURG studies. Recently, there has been a proliferation of experimental and clinical data supporting early androgen deprivation, including a reanalysis of the VACURG data, which suggests a survival advantage for younger patients with stage D disease and high-grade tumors who undergo androgen-ablative therapy at the time of diagnosis. The risk-benefit analysis presented in this review is strongly supportive of early hormonal therapy. Finally, long-term survival of patients with metastatic prostate cancer will require the development of novel treatment strategies effective against androgen-resistant tumor cells and their use in concert with early androgen deprivation.

Publication types

  • Review

MeSH terms

  • Androgen Antagonists / therapeutic use*
  • Animals
  • Diethylstilbestrol / therapeutic use
  • Humans
  • Male
  • Orchiectomy*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / therapy*
  • Time Factors

Substances

  • Androgen Antagonists
  • Diethylstilbestrol