Maximum Androgen Deprivation prior to Radical Retropubic Prostatectomy in Patients with Stage T(3) Adenocarcinoma of the Prostate

Radical prostatectomy in T4 prostate cancer after inductive androgen deprivation: results of a single‐institution series with long‐term follow‐up

“…Our present study corroborates historical data that described downstaging of patients with cT4 prostate cancer to clinically operable stages, which thereafter were safely treated by RP. In our present series, RP after inductive ADT was technically feasible with an overall complication rate as low as 23.2% and not exceeding Clavien–Dindo grade III within 90‐days after RP.…”

“…Previous studies of neoadjuvant ADT before RP showed a substantial reduction in prostate volume, as well as a decrease in PSA level, thus lowering the positive surgical margin rate and decreasing the number of pN1 cases [10][11][12]. In the few a b Our present study corroborates historical data [7,8] that described downstaging of patients with cT4 prostate cancer to clinically operable stages, which thereafter were safely treated by RP. In our present series, RP after inductive ADT was technically feasible with an overall complication rate as low as 23.2% and not exceeding Clavien-Dindo grade III within 90days after RP.…”

“…We furthermore had observed that the maximum tumour regression is reached at the time of PSA nadir, which is rather reliably achieved after 6–7 months of hormonal treatment. Preliminary experiences with this approach have been described by our group and others decades ago , but long‐term data of these series have never been published. Over many years, we used this concept in order to regain operability in motivated patients who presented with obviously inoperable tumours.…”

Differential Androgen Deprivation Therapies with Anti-androgens Casodex/Bicalutamide or MDV3100/Enzalutamide versus Anti-androgen Receptor ASC-J9® Lead to Promotion versus Suppression of Prostate Cancer Metastasis

“…Earlier reports showed that the PSA level may not reflect the pathological stage progression in some PCa patients, whose PSA levels were below 0.5 ng/ml with nodal metastasis after ADT (29,30). Meanwhile, a recent clinical trial of abiraterone, a powerful drug that suppressed androgen biosynthesis, also found that although 79% of PCa patients have a decline in PSA level of 50% or more, 52% of PCa patients have either increased new bone lesions or increased intensity of existing bone lesions, which these investigators called "bone scan flare," after 4 months of treatment (31).…”

Androgen Receptors in Untreated and Treated Prostatic Intraepithelial Neoplasia

“…This suggests a functional role of AR in hormone resis tance of PIN, explaining the observation that in all treated PIN AR continued to be present. Neoadjuvant endocrine combination therapy of pa tients with organ-confined prostatic carcinoma may result in tumor down-staging in a proportion of patients [17][18][19]. Prostatic adenocarcinoma cells can respond to endo crine therapy in roughly three ways: (1) entering into apoptosis, resulting in the rapid disappearance of these cells; (2) persistence for several months, with regressive changes and loss of mitotic activity, and (3) progressive growth.…”