When in a @entity1 with metastatic @entity263 progression of @entity5 growth occurs during first-line endocrine therapy the prognosis appears to be poor. In the literature there are only a few reports about the efficacy of second-line treatment with castration or @entity2931 indicating a mean response rate of 15-20%. The most effective sequence of endocrine therapy has not been determined. Therefore we have evaluated the data of 932 @entity1 treated for @entity263 between 1970-1980 in our hospital. Of these 932 @entity1 516 (55%) had @entity3 . In 275 @entity1 (53% of the @entity1 with @entity3 ) the @entity3 were already detected at time of diagnosis of the primary @entity5 . Adjuvant therapy appeared to cause a delay in the occurrence of overt @entity3 but (nearly) not an improvement of overall survival for @entity1 who developed @entity3 . We found no relationship between survival from the time of presentation of @entity3 and age. The median survival after occurrence of @entity3 was 18 months with a 5-year survival of 10%. From start of second-line therapy the median survival appeared to be only 6 months with a death rate of 3 times as high as from start of first-line therapy. Looking into our data one could be tempted to express that 1) the combination of castration plus @entity2931 as a first-line therapy seems to have a somewhat better effect on survival than other forms of endocrine therapy; 2) that as a second-line therapy castration appeared a suitable form of treatment after @entity2931 , antiandrogens after castration and @entity2931 when antiandrogens were used in the first line.

Orchidectomy and XXXX as secondary forms of treatment for metastatic @entity263 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostatic cancer'] @entity2931 :: ('CHEBI:50114', 'Chemical') :: ['oestrogens'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumour'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases', 'metastatic disease']
@entity2931 :: (CHEBI:50114,Chemical) :: ['oestrogens']
