The Effect of Neoadjuvant Hormonal Treatment in Prostate Cancer on Biochemical Recurrence / 대한비뇨기과학회지

ABSTRACT

PURPOSE: When combined with surgery, neoadjuvant hormonal therapy (NHT) has not demonstrated a significant benefit for meaningful clinical endpoints such as progression-free survival or overall survival. We evaluated the effect of NHT on prostate cancer. MATERIALS AND METHODS: From 1995 to 2004, 519 patients underwent radical retropubic prostatectomy(RRP). One-hundred thirty of them were included in this retrospective case-control study and they were assessed for age, the preoperative prostate-specific antigen(PSA) level, the clinical stage and the biopsy Gleason score(GS). The subjects were divided into two groups the RRP only group(n=65) and the NHT group(n=65), and these were matched for the 3 above mentioned parameters. The protocols for NHT were maximal androgen blockade(n=40), antiandrogen only(n=8), and LHRH analogue only(n=17). Biochemical recurrence was defined as a level of serum PSA of 0.2ng/ml or greater on 2 consecutive evaluations. RESULTS: The mean age of the RRP only group and the NHT group was 64.2 and 63.5, respectively(p>0.05). The rates of a positive surgical margin and biochemical recurrence in the NHT group were 49.2% and 42.5%, respectively, and they were 46.2% and 46.2%, respectively, in RRP only group, and there was no statistical difference between the two groups. In high risk patients(clinical stage> or =T3, biopsy GS> or =8, serum PSA>20ng/ml), NHT group was not differences compared with the RRP group. Neither the duration (3 months vs. 6 months) of NHT nor the regimens of NHT improved the clinical and surgical outcome. CONCLUSIONS: NHT did not improve biochemical recurrence and the positive surgical margin.