Yonsei Med J.  2013 Mar;54(2):410-415. 10.3349/ymj.2013.54.2.410.

Significance of Neoadjuvant Hormonal Therapy in Radical Retropubic Prostatectomy: A Retrospective Single-Surgeon Study

• Yamamichi
• Shigemura
• Morishita
• Yamanaka K
• Tanaka K
• Miyake H
• Fujisawa M

• KMID: 1503904
• DOI: http://doi.org/10.3349/ymj.2013.54.2.410

Abstract

PURPOSE
The purpose of this study was to evaluate whether neo-adjuvant hormonal therapy (NHT) prior to radical retropubic prostatectomy (RRP) for prostate cancer (PCa) is beneficial in terms of surgical outcomes and for preventing or delaying biochemical recurrence via single-surgeon case series study.
MATERIALS AND METHODS
Fifty-three men underwent RRP by a single surgeon. The patients were divided into two groups according to whether or not NHT was performed prior to RRP. The study was analyzed retrospectively. We evaluated clinical parameters, surgical parameters, and biochemical recurrence rate. Group 1 (n=34) was treated with RRP only, while Group 2 (n=19) underwent RRP along with NHT.
RESULTS
There were no significant differences in clinical, operation-related and pathological factors between the two groups (p>0.05). There was also no significant difference in biochemical recurrence rate between the two groups at the last follow-up, although Group 2 tended to have a lower PCa recurrence rate than Group 1 and the initial prostate-specific antigen (PSA) level was significantly higher in Group 2 than Group 1 (p=0.0496).
CONCLUSION
The present single-surgeon case series study revealed a trend toward a lower rate of PCa recurrence in NHT+RRP treated patients compared to those treated with RRP alone, but this did not reach statistical significance, despite the fact that NHT+RRP patients exhibited higher serum PSA levels preoperatively. Prospective studies with a longer duration of observation and a greater number of patients would be helpful in evaluating NHT more definitively.

Keyword

Neo-adjuvant hormonal therapy; radical retropubic prostatectomy; single surgeon study

MeSH Terms

Humans
Kallikreins/blood
Male
*Neoadjuvant Therapy
Preoperative Period
Prostate-Specific Antigen/blood
*Prostatectomy
Prostatic Neoplasms/*drug therapy/surgery
Recurrence
Retrospective Studies
Kallikreins
Prostate-Specific Antigen

Figure

• 

  Fig. 1 Kaplan-Meier curves for prostate-specific antigen (PSA) recurrence free survival until PSA failure according to treatment regimen Group 1: RRP only (shown as non-NHT) and Group 2: NHT before RRP plus RRP (shown as NHT). Biochemical recurrence rate does not show any significant difference between 2 arms. Log-rank test, p=0.3552. n.s., not significant; NHT, neo-adjuvant hormonal therapy; RRP, radical retropubic prostatectomy.

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