No abstract

alpha-Blockers were beneficial in the treatment of benign prostatic hyperplasia. Tolerance to treatment appeared to develop in a large proportion of patients after 6 months of therapy. However, for patients who benefit from long-term use of alpha-blockers effective treatment might be maintained for years.

The effect of Casodex (ICI 176,334), a new, once-daily, selective antiandrogen, given as 50 mg monotherapy, was compared with orchidectomy in a randomised, multicentre, open study in 376 patients with metastatic prostate cancer. At 3 months, PSA was reduced by 86% in the Casodex group and by 96% in the orchidectomy group. Treatment failed in 51 patients in the orchidectomy group and 66 showed a subjective response. Treatment failed in 86 patients treated with Casodex and 40 patients showed a subjective response. Patients treated with Casodex maintained their sexual interest better than those in the orchidectomy group. Median survival was significantly longer in the orchidectomy group. Casodex was well-tolerated. The most likely reason for the differences between the groups regarding time to treatment failure and survival is that the dose of Casodex was too small. Further studies with higher doses of Casodex are in progress.

These data indicate that computerized nuclear texture analysis as well as up regulation of sialyl Lewis(x) molecules may be new important prognostic factors in metastatic prostate cancer. Furthermore the prognostic importance of sedimentation rate, alkaline phosphatase and hemoglobin was confirmed.

A new texture operator, gray‐level entropy matrix (GLEM), was developed, and nine new textural features were extracted from this matrix. These textural features were applied to light microscopy images of nuclei taken from monolayers of advanced prostate cancer cells representing two different prognostic groups: hormone‐sensitive (good prognosis) and hormone‐resistant (poor prognosis) tumors. A comparison between the classification results obtained from GLEM features and those obtained from standard textural estimators is also discussed. Single features that gave correct classification rates better than 65% were included in a discriminant analysis in order to find the optimal set of features to discriminate between the two prognostic groups in the training data set. The best combination of features includes three GLEM features together with ENTROPY extracted from gray‐level cooccurrence matrix, and this combination gave a correct classification rate of 95% using the leaving‐one‐out technique. The influences of image sharpness and number of cells were also investigated. The features based on entropy or degree of scatter of minute structures can be used to discriminate between hormone‐sensitive and hormone‐resistant prostate carcinomas. © 1996 Wiley‐Liss, Inc.