Objective: Patients with metastatic prostate cancer who are initially treated by oral antiandrogens and then have progressive disease may be offered surgical castration as a second-line treatment. Twenty-eight such patients were reviewed to determine the outcome in terms of secondary PSA response, symptomatic relief and disease-specific survival.
Materials and methods: Retrospective chart-based review of patients undergoing bilateral scrotal orchidectomy after failure of antiandrogen monotherapy.
Results: Patients who had a >50% reduction in PSA at 12 weeks' postorchidectomy had significantly greater duration of PSA response and disease-specific survival. 64% of patients who had bone pain prior to orchidectomy had some relief of symptoms postoperatively. No prognostic indicators of improved survival were identified.
Conclusion: Orchidectomy as a secondary hormonal treatment following relapse on antiandrogens does produce a response in terms of PSA level and symptoms in some patients.