Source
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Marburg und Giessen, Standort Giessen, Giessen. vrohde@gmx.de
Abstract
PURPOSE:
This systematic review evaluates international data on the medical effectiveness of orchiectomy and medical therapy with LH-RH analogues in patients with advanced prostate cancer. These results are discussed in the context of primary, neoadjuvant, adjuvant and intermittent hormone deprivation.
MATERIALS AND METHODS:
A systematic, diversified literature analysis in the common medical and HTA databases and further media was conducted.
RESULTS:
All identified, randomised and controlled studies concerning the application of LH-RH analogues showed the same medical effectiveness for orchiectomy and for treatment with LH-RH analogues. Four different studies regarding the quality of life revealed no significant difference between the treatment with LH-RH analogues and the therapy with orchiectomy.
CONCLUSION:
According to available studies, there is clear evidence for the equivalent effectiveness of LH-RH analogues and orchiectomy in the treatment of advanced prostate cancer. A change back to orchiectomy - even though it is more cost-efficient - cannot be recommended when taking the extended indications for temporary hormone deprivation into consideration.