Pituitary Ablation and Disseminated Prostatic Carcinoma

Abstract

Twenty-seven patients with disseminated carcinoma of the prostate underwent adenohypophysectomy by either open craniotomy (8 patients) or stereotaxic cryohypophysectomy (19 patients). All patients had growth hormone assay following insulin-induced hypoglycemia during the preoperative (control) period and twice during the postoperative (experimental) period. In the postoperative tests, a 73% or greater suppression of growth hormone levels following hypoglycemia correlated with significant clinical remission and prolongation of survival. The minimal degree of growth hormone suppression consistent with clinical remission and extended survival was shown to be between 22% and 73% (as compared with preoperative control values). Subtotal hypophysectomy is adequate to achieve significant clinical remission and extended survival. Growth hormone assay is a useful index of the adequacy of hypophysectomy.