Assessments of Neoadjuvant Hormone Therapy Followed by Robotic-Assisted Radical Prostatectomy for Intermediate- and High-Risk Prostate Cancer

Abstract

Background/aim: It is still unclear whether neoadjuvant hormone therapy (NHT) followed by radical prostatectomy is the best treatment option for advanced prostate cancer. This study aimed to evaluate the benefits of NHT followed by robotic-assisted laparoscopic radical prostatectomy (RaLP) in locally advanced prostate cancer.

Patients and methods: This study included 48 patients that had received NHT prior to RaLP by a single surgeon. The control group was selected using computerized 1:1 ratio matching. General characteristics, peri-operative parameters, and oncologic outcomes were analyzed retrospectively.

Results: Significantly shorter operative time, lesser blood loss and lower positive surgical margins were reported in the NHT group. The median period to biochemical recurrence (BCR) was shorter (3 months vs. 5 months, p=0.0145) and the overall BCR rate was lower (54.17% vs. 87.5%, p=0.0243).

Conclusion: NHT followed by RaLP may provide clinicopathological benefits, especially in patients with pre-operative PSA values between 10-20 and above 50. Further prospective studies are needed to assess the impacts of NHT.

Keywords: Prostate cancer; hormone therapy; neoadjuvant; radical prostatectomy; robotic.