URO2 Complete regression of metastatic prostate cancer with LHRH monotherapy. (Urology).

URO2 COMPLETE REGRESSION OF METASTATIC PROSTATE CANCER WITH LHRH MONOTHERAPY Chad P. Huckabay, MD, Belur J. Patel, MD, and K. Scott Coffield, MD. Scott and White Hospital and Clinics, Texas A&M College of Medicine and Health Sciences Center, Temple, Tex.

The purpose of this study was to reveal radiologic and biochemical evidence for complete regression of locally metastatic prostate cancer with leuprolide treatment alone and discuss possible mechanisms of tumor regression. A retrospective review of a patient's chart with a history of rising PSA after radical retropubic prostatectomy was reviewed. The patient's PSA values, pathologic specimen and biopsies, radiologic studies, and clinical condition were charted. Moreover, a review of the literature was performed for similar reports of prostate cancer regression with hormonal therapy alone. Literature regarding the tumor regression and mechanisms of cell death was also reviewed. A 4 x 7.5 cm mass just behind and above the bladder showed complete disappearance on CT scan after ten months of treatment with leuprolide alone. The patient's PSA became undetectable (< 0.1) from a peak of 201 at recognition of local recurrence. Biopsy of the mass showed moderately differentiated adenocarcinoma. His original pathology at radical retropubic prostatectomy (RRP) and pelvic node dissection was T3bN0M0, Gleason's score 9. The patient survives 15 years after initial biopsy and RRP and 7.5 years after treatment and complete regression of the recurrent prostate cancer. Review of the literature showed no similar cases. There was one case of abdominal recurrence with 94% remission after treatment with hormonal therapy and radiation. Prostate cancer metastatic to the pituitary fossa has been reported to respond partially to hormonal therapy. LHRH agonists are important modalities in the treatment of metastatic prostate cancer. Prostate cancer cell lines have been shown to undergo apoptosis after treatment with LHRH agonists such as leuprolide and the possibility of complete tumor regression. Proven radiographic and biochemical complete response to leuprolide therapy highlights the cruciality of hormonal treatment for metastatic prostate cancer.