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Neoadjuvant Hormonal Therapy Prior to Radical Prostatectomy
1Department of Pathology, University of Miami School of Medicine, Miami, Florida.
Molecular Urology
|June 14, 2000
Summary
Neoadjuvant hormonal therapy (NHT) for prostate cancer may reduce positive surgical margins in high-risk patients. However, this study found no significant impact on disease-free survival after 24 months.
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Neoadjuvant hormonal therapy (NHT) is used for localized prostate cancer.
- Previous studies like the US T(2b) trial suggested potential benefits in reducing positive margins.
Purpose of the Study:
- To evaluate the impact of NHT on surgical outcomes and disease recurrence in clinically localized prostate cancer.
- To address criticisms of prior studies by using a single surgeon and pathologist for central review.
Main Methods:
- A nonrandomized review of 109 patients receiving NHT plus prostatectomy versus 145 patients receiving prostatectomy alone.
- Follow-up was conducted for 24 months, analyzing positive margins, biochemical recurrence (PSA), and metastasis incidence.
Main Results:
- Positive surgical margins decreased from 38% in the untreated group to 28% in the NHT-treated group (statistically significant).
- Biochemical recurrence was higher in the NHT group but not statistically significant.
- No significant differences were observed in extracapsular extension, seminal vesicle invasion, or lymph node metastasis.
Conclusions:
- NHT in high-risk prostate cancer patients significantly reduces positive surgical margins.
- NHT did not demonstrate an impact on disease-free survival at a mean 24-month follow-up.