Pathological effects of neoadjuvant hormonal therapy help predict progression of prostate cancer after radical prostatectomy.
BACKGROUND
It is not clear whether pathological changes following neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy have any value as predictors of progression in prostate cancer.


METHODS
We conducted a study of 100 patients with prostate cancer who underwent radical prostatectomy following NHT. We used the Japanese general rule as the criterion to assess the biochemical recurrence rate and pathological changes after NHT.


RESULTS
In terms of preoperative risk factors, the probability of recurrence was significantly higher for patients with more than 20 ng/mL of pretreatment serum prostate-specific antigen (PSA) and/or a Gleason score of 7 or higher for biopsy specimens. We defined these pretreatment findings as high-risk factors. Among 65 patients with high-risk factors, patients with a post-NHT pathological effect of grade 3 according to the Japanese general rule showed no recurrence, whereas patients with a grade 0 had a poor prognosis. Patients with a PSA nadir 0.5 ng/mL or less tended to have a better prognosis.


CONCLUSIONS
Despite preoperative high-risk factors, patients showing good pathological effects after NHT tend to have a favorable prognosis after radical prostatectomy. Therefore; assessment of the pathological effects of NHT using the Japanese general rule as the criterion proved to be useful for the prediction of biochemical recurrence.
Kitagawa
Yasuhide
Y
Department of Urology, National Kanazawa Hospital, Kanazawa, Japan.
Koshida
Kiyoshi
K
Mizokami
Atsushi
A
Komatsu
Kazuto
K
Nakashima
Shinichi
S
Misaki
Toshimitsu
T
Katsumi
Tetsuo
T
Namiki
Mikio
M
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000187:drug effects*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment
D000726:Androgen Antagonists; D017430:Prostate-Specific Antigen