Therapeutic approaches in prostatic cancer

Surgical castration combined to cyproterone acetate treatment in patients with advanced prostatic carcinoma, gives satisfactory clinical results in 75% of the cases, with a follow-up period of 12-59 months. Histological tumour grading, tissue dihydrotestosterone (DHT) concentrations and DNA distribution by flow-cytometry in the tumoral cells are significantly correlated with the clinical response to hormonal therapy, whilst cytosol androgen receptors are not. 17 cases with DHT levels greater than 1.8 ng/g tissue are in remission (COR, POR or OS), whereas 5 cases with DHT levels less than 1.8 ng/g are in progression. In the responder group diploid DNA pattern is found in 20 cases and aneuploidy in 7, whilst in the not responder group aneuploidy was found in 5 cases and diploidy in 2. In conclusion histological grading and measurement of DNA and DHT in tumour tissue may be complementary in the prospective identification of the hormonally dependent tumours, which may benefit of the combined endocrine therapy suppressing androgens of testicular and adrenal origin.