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KMID : 0358320070480111125
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Korean Journal of Urology
2007 Volume.48 No. 11 p.1125 ~ p.1130
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The Effect of Neoadjuvant Hormonal Treatment in Prostate Cancer on Biochemical Recurrence
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Song Kang-hyon
Park Hong-Zoo
Han Ji-Yeon
Yoo Chang-Hee
Ahn Han-Jong
Kim Choung-Soo
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Abstract
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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≥T3, biopsy GS≥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
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KEYWORD
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Prostate cancer, Neoadjuvant therapy, Recurrence
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