Short-term clinicopathological outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade, followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with high-risk localized prostate cancer.
BACKGROUND
To assess the outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with a high risk of localized prostate cancer (PCa).


METHODS
Complete androgen blockade followed by 6 cycles of docetaxel (30 mg/m2) with estramustine phosphate (560 mg) were given to 18 PCa patients before radical prostatectomy. Subsequently, the clinical and pathological outcomes were analyzed.


RESULTS
No patients had severe adverse events during chemohormonal therapy, and hence they were treated with radical prostatectomy. Two patients (11.1%) achieved pathological complete response. Surgical margins were negative in all patients. At a median follow-up of 18 months, 14 patients (77.8%) were disease-free without PSA recurrence. All 4 patients with PSA recurrence had pathologic T3b or T4 disease and 3 of these 4 patients had pathologic N1 disease.


CONCLUSIONS
We found that neoadjuvant chemohormonal therapy with complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy was safe, feasible, and associated with favorable pathological outcomes in patients with a high risk of localized PCa.
Department of Urology, Akita University School of Medicine, Akita, Japan.
Shintaro
S
Narita
Norihiko
N
Tsuchiya
Teruaki
T
Kumazawa
Shinya
S
Maita
Kazuyuki
K
Numakura
Takashi
T
Obara
Hiroshi
H
Tsuruta
Mitsuru
M
Saito
Takamitsu
T
Inoue
Yohei
Y
Horikawa
Shigeru
S
Satoh
Hiroshi
H
Nanjyo
Tomonori
T
Habuchi
D000368:Aged; D000728:Androgens / Q000378:metabolism*; D000813:Anilides / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D000077143:Docetaxel; D004961:Estramustine / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D009570:Nitriles / Q000008:administration & dosage; D017430:Prostate-Specific Antigen; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D014105:Tosyl Compounds / Q000008:administration & dosage; D016896:Treatment Outcome
D000728:Androgens; D000813:Anilides; D009570:Nitriles; D043823:Taxoids; D014105:Tosyl Compounds; D000077143:Docetaxel; D004961:Estramustine; C053541:bicalutamide; D017430:Prostate-Specific Antigen; D016729:Leuprolide