Short-term benefit of neoadjuvant hormone therapy in patients with localized high-risk or limited progressive prostate cancer

Bing-Lei Ma,1,2,* Lin Yao,1,2,* Yu Fan,1,2 Yu Wang,1,2 Yi-Sen Meng,1,2 Qian Zhang,1,2 Zhi-Song He,1,2 Jie Jin,1,2 Li-Qun Zhou1,21Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Urogenital Diseases (male), Molecular Diagnosis and Treatment Center, Beijing, People’s Republic of China*These authors contributed equally to this workPurpose: Radical surgery is the preferred method for local high-risk and limited progressive prostate cancer in the routine clinical setting. However, current guidelines do not recommend neoadjuvant hormone therapy (NHT). Opinions regarding NHT vary among individual clinicians. According to the experience gained at our center, we explored the benefits of NHT for patients with prostate cancer during the perioperative period in this study.Methods: In this retrospective study, we explored the perioperative benefits of NHT among 189 patients with local high-risk or limited progressive prostate cancer who underwent radical prostatectomy and divided them into two groups: the NHT group and the non-NHT group. The NHT regimens were a gonadotropin-releasing hormone (GnRH) agonist alone (3.75/11.25 mg of leuprolide or 3.6/10.8 mg of goserelin acetate), an androgen receptor antagonist (ARA) alone, or a combination of the two. The duration of treatment was <3 months, 3 to 6 months, or >6 months.Results: We found that NHT could reduce the surgery time and intraoperative hemorrhage, thus reducing the difficulty of surgery; NHT could also improve the postoperative recovery of patients. However, it did not reduce the stage of prostate cancer or positive surgical margin rate.Conclusions: Neoadjuvant therapy is optional for some patients. We believe that NHT will improve the overall prognosis of patients as progress continues in the medical field in the future.Keywords: localized high-risk, limited advanced, prostate cancer, neoadjuvant hormone therapy, short-term benefi