Neoadjuvant Androgen Deprivation Therapy Prior to Radical Prostatectomy: Recent Trends in Utilization and Association with Postoperative Surgical Margin Status

McClintock, Tyler R.; Landenberg, Nicolas von; Cole, Alexander P.; Lipsitz, Stuart R.; Gild, Philipp; Sun, Maxine; Fletcher, Sean A.; Roghmann, Florian; Menon, Mani; Nguyen, Paul L.; Noldus, Joachim; Choueiri, Toni K.; Kibel, Adam S.; Trinh, Quoc‐Dien

doi:10.1245/s10434-018-7035-z

Cited by 21 publications

(18 citation statements)

References 29 publications

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“…Available evidence indicated that the use of neoadjuvant ADT in RP candidates could reduce positive surgical margin rates, EPE rates and lymph node involvements [ 26 , 27 ]. Of note, these benefits only occurred in high-risk patients [ 28 ]. With the widespread application of PSMA-PET-CT [ 29 , 30 , 31 ] and single-cell sequencing [ 32 , 33 ], early micrometastasis is considered to be one critical cause for biochemical recurrence or progressive metastasis after radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Deep Learning with Quantitative Features of Magnetic Resonance Images to Predict Biochemical Recurrence of Radical Prostatectomy: A Multi-Center Study

Yan

Shao

Liu

et al. 2021

Cancers

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Biochemical recurrence (BCR) occurs in up to 27% of patients after radical prostatectomy (RP) and often compromises oncologic survival. To determine whether imaging signatures on clinical prostate magnetic resonance imaging (MRI) could noninvasively characterize biochemical recurrence and optimize treatment. We retrospectively enrolled 485 patients underwent RP from 2010 to 2017 in three institutions. Quantitative and interpretable features were extracted from T2 delineated tumors. Deep learning-based survival analysis was then applied to develop the deep-radiomic signature (DRS-BCR). The model’s performance was further evaluated, in comparison with conventional clinical models. The model achieved C-index of 0.802 in both primary and validating cohorts, outweighed the CAPRA-S score (0.677), NCCN model (0.586) and Gleason grade group systems (0.583). With application analysis, DRS-BCR model can significantly reduce false-positive predictions, so that nearly one-third of patients could benefit from the model by avoiding overtreatments. The deep learning-based survival analysis assisted quantitative image features from MRI performed well in prediction for BCR and has significant potential in optimizing systemic neoadjuvant or adjuvant therapies for prostate cancer patients.

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Section: Discussionmentioning

confidence: 99%

Deep Learning with Quantitative Features of Magnetic Resonance Images to Predict Biochemical Recurrence of Radical Prostatectomy: A Multi-Center Study

Yan

Shao

Liu

et al. 2021

Cancers

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“…The efficacy and safety of neoadjuvant ADT for 4 months has been reported previously in a small study. A recent review of the National Cancer Database revealed that the use of neoadjuvant hormonal therapy prior to radical prostatectomy has increased over the last few years [19] . It is important to note that the role of neoadjuvant ADT prior to surgery for high‐risk disease remains undetermined, and is currently a subject of randomized controlled trials.…”

Section: Delayed Surgery and Adverse Outcomesmentioning

confidence: 99%

Management of urologic cancers during the pandemic and potential impact of treatment deferrals on outcomes

Mian

Siddiqui

Ahmad

2021

Urologic Oncology: Seminars and Original Investigations

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Highlights Urothelial, testicular, and penile cancers treatment should proceed without delay. Initial treatment was modified most frequently for prostate and renal cancers. 1 in 7 uro-oncologists witnessed adverse outcomes from delayed care within 6 months. Worldwide surveys show that urologic cancers treatment was only partially disrupted. Prioritization of cancer care could limit the negative impact of delays due to pandemic.

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“…For these reasons, and concern about the significant side effects of hormonal therapy [11], NHT for patients who receive RP is not recommended in any guidelines [26,27]. However, in clinical practice, there is a modest trend towards increased utilization of NHT before RP [28]. Furthermore, in this COVID-19 era, RP for localized prostate cancer is regarded as a non-priority surgery, and many surgeries are postponed until after the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Negative impact of neoadjuvant hormonal therapy on detecting biochemical recurrence after radical prostatectomy

et al. 2021

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Background Routine use of neoadjuvant hormonal therapy (NHT) before radical prostatectomy (RP) is not recommended, but it is sometimes performed to reduce the prostate size and tumor volume or to prevent tumor progression during the wait times for surgery in clinical practice. On the other hand, the impact of NHT on the pattern of biochemical recurrence (BCR) is unknown. Methods We retrospectively examined 1749 consecutive patients who underwent RP between 1996 and 2017. Among the patients who met the inclusion criteria, BCR developed in 240 of non-NHT patients and in 120 of NHT patients during the mean follow-up period of 6.9 years. We examined the impact of NHT on the PSA-doubling time (DT) following BCR at different times after RP. Results The median PSA-DTs in non-NHT patients who experienced BCR in the first year after surgery, between 1 and 2 years, between 2 and 3 years, between

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Neoadjuvant Androgen Deprivation Therapy Prior to Radical Prostatectomy: Recent Trends in Utilization and Association with Postoperative Surgical Margin Status

Cited by 21 publications

References 29 publications

Deep Learning with Quantitative Features of Magnetic Resonance Images to Predict Biochemical Recurrence of Radical Prostatectomy: A Multi-Center Study

Deep Learning with Quantitative Features of Magnetic Resonance Images to Predict Biochemical Recurrence of Radical Prostatectomy: A Multi-Center Study

Management of urologic cancers during the pandemic and potential impact of treatment deferrals on outcomes

Negative impact of neoadjuvant hormonal therapy on detecting biochemical recurrence after radical prostatectomy

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