Ureteral obstruction from prostatic carcinoma: response to endocrine and radiation therapy

Ureteral obstruction occurred in 10% of the patients treated for prostatic carcinoma and most often was associated with poorly differentiated tumors. The response of ureteral obstruction to different forms of therapy was evaluated. Obstruction diminished in 22 of 25 orchiectomized patients (88%) but in only 1 of 6 patients receiving estrogen or antiandrogen therapy alone (17%). Patients who responded favorably to therapy had a significantly better survival than did non-responders. Patients treated early in the course of ureteral obstruction responded better than those treated late, while neither tumor stage nor grade correlated with response to therapy. Radiation therapy for endocrine-resistant ureteral obstruction was effective in only 2 of 8 cases (25%). The literature on ureteral obstruction from prostatic carcinoma and its treatment is reviewed.