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[Prostatic carcinoma. Radical prostatectomy. Impact of neoadjuvant hormonal treatment]
J J Zudaire Bergera1, D Sánchez Zalabardo, J Arocena García-Tapia
1Departamento de Urología, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona.
Objective:
To assess the influence of neo-adjuvant hormone therapy on the pathologic stage, margins and disease-free survival in patients with T1-T2 prostate cancer after radical prostatectomy.
Material And Methods:
Forty-two non-randomised, T1-T2 patients who underwent complete neo-adjuvant blockade and radical prostatectomy between 1988-1998 were included in the study. This group is part of a larger cohort of 220 T1-T2 patients treated with radical surgery. The group is compared to: a) the remaining patients (178) (Group I) and b) a selected group (54 patients) of consistent characteristics relative to clinical variables (Group II). Mean follow-up: 35 months; median: 32 months.
Results:
Compared to Group I patients with neo-adjuvant therapy show worse Gleason (p: 0.01), worse clinical stage (p: 0.02), higher rate of patients with high clinical risk (p: 0.03), and higher PSA (though not statistically different). No differences were seen relative to pathological status or margins. Compared to Group II (54 patients) no differences are found in clinical or pathological variables. Groups are comparable in terms of progression-free survival.
Conclusions:
Neo-adjuvant hormone therapy in high clinical risk, T1-T2 patients does not involve improvement in pathological stage, margins or progression-free survival.