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Related Experiment Video

Updated: Jul 9, 2026

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Neoadjuvant Chemohormonal Therapy for Patients With Very-high Risk Localized Prostate Cancer in Clinical Stages T2

Daiki Kikuchi1, Kazuyuki Numakura2, Kotona Miyauchi1

  • 1Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Japan.

In Vivo (Athens, Greece)
|February 27, 2026
PubMed
Summary

Neoadjuvant chemohormonal therapy (NCHT) did not improve biochemical recurrence-free survival in very-high risk prostate cancer patients. Tumor biology, specifically Gleason pattern 5, was a more significant predictor of outcomes than NCHT.

Keywords:
Localized prostate cancerchemohormonal therapyneoadjuvant therapyrobot-assisted radical prostatectomy

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Area of Science:

  • Oncology
  • Urology
  • Prostate Cancer Research

Background:

  • The efficacy of neoadjuvant chemohormonal therapy (NCHT) for very-high risk localized prostate cancer is uncertain.
  • Previous studies often included heterogeneous patient groups with locally advanced disease, limiting conclusions for strictly defined early-stage cancers.

Purpose of the Study:

  • To evaluate the clinical significance of NCHT in patients with very-high risk prostate cancer strictly defined as T2-T3a.
  • To assess the impact of NCHT on biochemical recurrence-free survival (BRFS).

Main Methods:

  • Retrospective analysis of 49 patients with very-high risk prostate cancer (T2-T3a).
  • Comparison between 25 patients receiving NCHT (androgen deprivation therapy and estramustine phosphate) and 24 patients undergoing radical prostatectomy alone.
  • All patients underwent robot-assisted radical prostatectomy with extended lymph node dissection.

Main Results:

  • No significant difference in BRFS was observed between the NCHT and non-NCHT groups (p=0.397).
  • Primary Gleason pattern 5 was identified as the sole independent predictor of BRFS (HR=3.72).
  • NCHT did not confer a significant oncological benefit in this cohort.

Conclusions:

  • NCHT does not appear to improve biochemical recurrence outcomes for patients with very-high risk prostate cancer limited to T2-T3a disease.
  • Tumor biology, particularly primary Gleason pattern 5, is a more critical prognostic factor than neoadjuvant systemic therapy.
  • Further large-scale, prospective studies are needed to determine the optimal use of neoadjuvant approaches in selected prostate cancer patients.