The role of neoadjuvant androgen deprivation prior to radical prostatectomy

Androgen ablation prior to radical prostatectomy currently is under investigation with the goal of improving cancer control in patients with clinically treated localized prostate cancer. Results of several randomized studies have shown a significant pathologic downstaging and a decrease in the rate of positive surgical margins using neoadjuvant therapy in stage B cancers. Despite theoretic advantages, neoadjuvant therapy may have side effects and is associated with costs. Until long-term results of biologic and clinical failure rates are available, this approach should be considered investigational.