The risk of malignancy in the surgical margin at radical prostatectomy reduced almost three-fold in patients given neo-adjuvant hormone treatment.
OBJECTIVE
To investigate the outcome of neo-adjuvant hormone treatment before radical prostatectomy regarding local tumour extension, peri-operative blood loss and operation time.


METHODS
Of 111 surgically treated patients with prostate cancer (T1b-T3a, N0, M0, G1-3), 55 were randomised to immediate radical prostatectomy and 56 to 3 months of neo-adjuvant treatment with triptorelin (3.75 mg i.m. every 28 days) and cyproterone acetate (50 mg b.i.d. for 3 weeks to prevent flare).


RESULTS
No differences were found in blood loss or operation time but patients who had neo-adjuvant treatment had a significantly lower frequency of positive margins (41 vs. 23%, p = 0.013).


CONCLUSIONS
Neo-adjuvant treatment does not facilitate radical prostatectomy but may improve the chance of local cure. This must, however, be documented with long-term follow-up in randomised patients.
Hugosson
J
J
Department of Urology, Göteborg University, Sweden.
Abrahamsson
P A
PA
Ahlgren
G
G
Aus
G
G
Lundberg
S
S
Schelin
S
S
Schain
M
M
Pedersen
K
K
D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D016063:Blood Loss, Surgical; D017024:Chemotherapy, Adjuvant; D017373:Cyproterone Acetate / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017329:Triptorelin Pamoate; D013739:Testosterone; D017373:Cyproterone Acetate; D017430:Prostate-Specific Antigen