Neoadjuvant Androgen Deprivation Therapy Effects on Perioperative Outcomes Prior to Radical Prostatectomy: Eleven Years of Experiences at Ramathibodi Hospital

Abstract

Objective The aim of this study was to demonstrate the efficacy of neoadjuvant androgen deprivation therapy (NADT) on perioperative outcomes in patients who underwent radical prostatectomy (RP). Materials and Methods From January 2008 to July 2018, we collected retrospective data of patients with clinically localized prostate cancer who underwent RP to assess their perioperative and pathological outcomes. The data included age, body mass index (BMI), serum prostate specific antigen (PSA) level, clinical stage, neoadjuvant ADT usage, operative time, estimated blood loss (EBL), perioperative complications, blood transfusion rate, adjacent organ injury rate, length of hospital stay, pathological stage, Gleason score (GS) of the biopsy and pathological specimen, specimen weight (g), and margin status. Results Of the 718 RPs performed, 138 (19.22%) were NADT and 580 (80.78%) were non-NADT. Patients who underwent NADT had a significant benefit in operative time (185 vs 195 mins), EBL (300 vs 500 mL) and specimen weight. These benefits were more obvious in non-low risk prostate cancer with less operative time, EBL, blood transfusion rate, length of hospital stay and specimen weight. However, the margin status and adjacent organ injury rate were similar in the NADT and non-NADT groups. Conclusion NADT provides significantly better perioperative outcomes, especially in non-low risk prostate cancer, and has comparable pathological outcomes.

Clinical Analysis of Perioperative Outcomes on Neoadjuvant Hormone Therapy before Laparoscopic and Robot-Assisted Surgery for Localized High-Risk Prostate Cancer in a Chinese Cohort

“…However, the clinical findings of neoadjuvant hormone therapy (NHT) before radical prostatectomy are inconsistent among various studies. Some studies have found that neoadjuvant hormone therapy prior to RP helps reduce the incidence of positive surgical margins and lymph node infiltration [ 7 , 8 ], but others have suggested that neoadjuvant hormone therapy prior to RP does not have a significant survival benefit for patients, including overall survival and disease-free survival [ 9 ], and therefore preoperative neoadjuvant therapy is not specifically recommended by current guidelines for patients with high-risk prostate cancer.…”

Radical prostatectomy outcomes in renal transplant recipients: a retrospective case series of Thai patients

“…We performed ORP in a retropubic fashion through a low midline incision (Fig. 1 A) according to our regular ORP approach [ 10 ]. Briefly, the space of Retzius was developed using blunt and sharp dissection along the outside of the left umbilical ligament.…”

“…The LRP was performed in an extraperitoneal fashion using 5 trocars with some modification from the standard port positions [ 10 ] to facilitate graft injury prevention (Fig. 1 B, C).…”

“…In general, the procedures of RALRP in RTR were not different from RALRP in general patients but the trocars were placed slightly medially (Fig. 1 E, F, G) from the standard port sites [ 10 ] (Fig. 1 D) to deliver sufficient access without graft injury.…”