Neoadjuvant Chemohormonal Pretreatment for High-Risk Localized Prostate Cancer
Posted: Monday, April 15, 2019
Neoadjuvant chemohormonal therapy before radical prostatectomy may reduce the risk of biochemical recurrence in patients with high-risk prostate cancer, according to a study by Shintaro Narita, MD, PhD, of the Akita University School of Medicine, Japan, and colleagues. However, they noted, the possibility of perioperative complications should be considered. The findings of this comparative analysis were published in Clinical Genitourinary Cancer.
“Although surgical complications were relatively frequent in the neoadjuvant chemohormonal therapy and radical prostatectomy group, these results are promising and suggest that our neoadjuvant chemohormonal therapy protocol could lengthen biochemical recurrence-free survival in patients with high-risk prostate cancer,” the investigators commented.
A total of 60 patients received neoadjuvant chemohormonal therapy before radical prostatectomy. The neoadjuvant therapy included androgen blockade before 6 cycles of docetaxel (30 mg/m2) and estramustine phosphate (560 mg). Using propensity score matching, the results of these 60 patients were compared with the outcomes of 349 patients with high-risk prostate cancer who underwent radical prostatectomy alone. The Michinoku Japan Urological Cancer Study Group database provided the health records of the latter group.
For patients who received neoadjuvant chemohormonal therapy, 10% had a pathologic complete response, 3.3% had positive surgical margins, and 13.3% had severe complications following radical prostatectomy. With a median follow-up of 42.5 months, the 5-year biochemical recurrence-free survival was 60.1%. The biochemical recurrence rate in the neoadjuvant chemohormonal therapy group was lower than that in the radical prostatectomy alone group using propensity score matching.
Disclosure: The study authors’ disclosure information may be found at clinical-genitourinary-cancer.com.