Efficacy of neoadjuvant hormonal treatment before radical prostatectomy for locally advanced high-risk prostate carcinomas

DOI: 10.22591/magyurol.2019.1.berczics.3

Authors:
Berczi Csaba dr., Kiss Zoltán dr., Flaskó Tibor dr.
Debreceni Egyetem Általános Orvostudományi Kar, Urológiai Tanszék, Debrecen (igazgató: Flaskó Tibor dr.)

Summary

Aims: To measure the efficacy of neoadjuvant hormonal treatment before radical prostatectomy in patients with locally advanced high-risk prostate carcinomas.
Methods: From January 1996 to January 2018, 105 patients underwent radical prostatectomy for locally advanced high-risk prostate cancer. In Group 1 the patients received neoadjuvant hormonal therapy (n: 37), while in Group 2 the patients didn’t receive neoadjuvant hormonal treatment (n:68). In Group 1, the mean age of the patients was 64.1±6.8 years and the mean PSA level was 31.5 ng/ml. In Group 2, the mean age of the patients was 63.7±6.3 years, and the mean PSA concentration was 20.5 ng/ml. In all cases the preoperative radiological examinations showed locally advanced tumor.
Results: Histology showed locally advanced tumor (pT3) in 8 cases (21.6%) in Group 1, and in 41 patients (60.2%) in Group 2 (p=0.073). Margin positivity was detected in 8 occasions (21.6%) in Group 1, while it was present in 28 cases (41.7%) in Group 2 (p=0.043).
The median follow-up period was 58 month. In Group 1, biochemical progression developed in 8 patients (21.6%), local recurrence in 1case (2.7%) and distant metastasis in 3 occasions (8.1%) during this period. In Group 2, biochemical progression was diagnosed in 12 cases (17.6%), local recurrence in 3 patients (4.4%) and distant metastasis in 1 occasion (1.4%).
There were no significant deviations in these parameters in the two groups. Tumor specific mortality didn’t occur during the follow-up period.
Conclusions: The results showed that the neoadjuvant hormonal therapy provides better – but not significantly better – local tumor control in locally advanced high-risk prostate carcinomas. However, the neoadjuvant hormonal therapy didn’t prove any advantage according to tumor progression.

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