Transsphenoidal stereotaxic cryohypophysectomy for the management of pain in disseminated prostatic carcinoma.

Nineteen adult males with disseminated carcinoma of the prostate gland associated with intractable pain were subjected to a transsphenoidal stereotaxic cryohypophysectomy. Growth hormone (GH) assays following insulin-induced hypoglycemia were obtained once during the preoperative and twice during the postoperative period. In the postoperative assays, a 73% or greater suppression of GH levels correlated with significant clinical remission and extended survival. In all patients who had as much as 73% reduction in GH level, pain relief occurred within 4 days or less after surgery. This study shows that subtotal hypophysectomy may be adequate to achieve satisfactory clinical remission and pain control. GH assay is a useful index of the adequacy of hypophysectomy.