Neoadjuvant hormonal therapy for prostate cancer
Miki, T.; Kamoi, K.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 28(7): 927-933
2001
ISSN/ISBN: 0385-0684 PMID: 11478141 Document Number: 539358
There have been expectations that neoadjuvant hormonal therapy would decrease the rate of positive surgical margins and, therefore, to improve the patient's survival rate after radical prostatectomy for clinically localized prostate cancer. A review of seven prospective randomized studies for clinically localized prostate cancer revealed a significant decrease in the positive surgical margin rate in cases of clinical T2 disease after neoadjuvant hormonal therapy with prostatectomy. However, this treatment did not alter the rate of seminal vesicle invasion or lymph node metastasis after radical prostatectomy. There was no difference in operative blood loss, operating time, complication rate or hospital stay between patients treated with neoadjuvant hormonal therapy and controls. Furthermore, there was no improvement in prostate specific antigen-free survival rate after a maximum of 4 years follow-up. Further research is required to determine the optimal duration of neoadjuvant hormonal therapy and whether this therapy increases the survival rate. Neoadjuvant hormonal therapy before radical prostatectomy is not supported by any outcome at this point and its use remains in the investigational stage.