ABSTRACT
The hormonotherapy constitutes since many years a major element of the palliative treatment of cancer prostate. It is effective at the beginning of the treatment, but a hormono resistance a ppears ofter few months. We led a prospective study spread out over 20 months, for 6 cases. Our object was to detect Cancer prostate that is beyond the hormonal control and study - thanks to biopsies - the interesting possible histological modifications both in the normal and cancerous prostatic tissue. Our study included 6 patients with a mean age of 72 years and 6 months. At the time of the exhast 3 patients were presented with neuroendocrine differentiation. The other 3 patients were without neuroendocrine differentiation, and had at the time of diagnosis an osseous metastases. Their initiale average PSA was of 83,40ng/ ml, and of 161,23 ng/ml in exhust. The group with neuroendocine differentiations these values were of 21,95 ng/ml and 37,55 ng/wa respectively. The average time of exhust in neuroendocine differentiation was of 19 months, against 17 mouths for the group without neuroendocrine diffrentiation. Severad histological tranformations were reported in the hormonal exhust of cancer porstate, the most known were: reduction of tumoral volume, capsular invasion, as well as a smaller percentage of positive marginal resection, compared with cancer that ever treated by hormonotherapy. Certain authers also noted an increase of Gleason score in the hormono-resistant prostate. Lastly, the paramete which draws more the attention of authers was that the neuroendocrine differentiation type may be concidered as a mechanisme implied in the exhust. In our study, half of the cases in exhust presented with a neuroendocrine differentiation, that would be concideved as a prognostic factor according to certain authers, wheras others are nof convinced by its prognostic implication. The study of the histological modifications in hormono-resistant cancer of the prostate is of an main interest for the anatomopathologists, as well as for the urologists and the oncologists so as not to interpret the observed histological images incorrectly, which could establish a based prognosis and inadequate therapeutic care. The implication of these transformations remain still vague and several studies will be necessary in order to clear up the various persistent points of shade