RRU_A_312128 303..312

1Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Urology, Department of Surgery, Police Hospital, Bangkok, Thailand Objective: The aim of this study was to demonstrate the efficacy of neoadjuvant androgen deprivation therapy (NADT) on perioperative outcomes in patients who underwent radical prostatectomy (RP). Materials and Methods: From January 2008 to July 2018, we collected retrospective data of patients with clinically localized prostate cancer who underwent RP to assess their perioperative and pathological outcomes. The data included age, body mass index (BMI), serum prostate specific antigen (PSA) level, clinical stage, neoadjuvant ADT usage, operative time, estimated blood loss (EBL), perioperative complications, blood transfusion rate, adjacent organ injury rate, length of hospital stay, pathological stage, Gleason score (GS) of the biopsy and pathological specimen, specimen weight (g), and margin status. Results: Of the 718 RPs performed, 138 (19.22%) were NADT and 580 (80.78%) were nonNADT. Patients who underwent NADT had a significant benefit in operative time (185 vs 195 mins), EBL (300 vs 500 mL) and specimen weight. These benefits were more obvious in non-low risk prostate cancer with less operative time, EBL, blood transfusion rate, length of hospital stay and specimen weight. However, the margin status and adjacent organ injury rate were similar in the NADT and non-NADT groups. Conclusion: NADT provides significantly better perioperative outcomes, especially in nonlow risk prostate cancer, and has comparable pathological outcomes.

[1]  S. Jacobsen,et al.  Neoadjuvant Leuprolide Therapy with Radical Prostatectomy: Long-term Effects on Health-related Quality of Life. , 2020, European urology focus.

[2]  G. Pignot,et al.  Identifying the relevant population for neoadjuvant chemo-hormonal therapy combined with radical prostatectomy. , 2020, Gland surgery.

[3]  Y. Choi,et al.  Effect of prostate gland weight on the surgical and oncological outcomes of extraperitoneal robot-assisted radical prostatectomy , 2019, BMC Urology.

[4]  Ronald C. Chen,et al.  Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Part I: Risk Stratification, Shared Decision Making, and Care Options , 2017, The Journal of urology.

[5]  P. Kantoff,et al.  Post prostatectomy outcomes of patients with high-risk prostate cancer treated with neoadjuvant androgen blockade , 2018, Prostate Cancer and Prostatic Diseases.

[6]  N. Soomro,et al.  Positive surgical margins and biochemical recurrence following minimally-invasive radical prostatectomy – An analysis of outcomes from a UK tertiary referral centre , 2017, BMC Urology.

[7]  K. Haustermans,et al.  The survival impact of neoadjuvant hormonal therapy before radical prostatectomy for treatment of high-risk prostate cancer , 2017, Prostate Cancer and Prostatic Diseases.

[8]  P. Kantoff,et al.  Neoadjuvant Enzalutamide Prior to Prostatectomy , 2016, Clinical Cancer Research.

[9]  C. Radulescu,et al.  Positive surgical margins after radical prostatectomy: What should we care about? , 2015, World Journal of Urology.

[10]  Stefan Carlsson,et al.  Short-term results after robot-assisted laparoscopic radical prostatectomy compared to open radical prostatectomy. , 2015, European urology.

[11]  T. Erdoğru,et al.  Open, laparoscopic and robot-assisted laparoscopic radical prostatectomy: comparative analysis of operative and pathologic outcomes for three techniques with a single surgeon's experience. , 2015, European review for medical and pharmacological sciences.

[12]  J. Eastham,et al.  Significance and management of positive surgical margins at the time of radical prostatectomy , 2014, Indian journal of urology : IJU : journal of the Urological Society of India.

[13]  S. Bezerra,et al.  Radical prostatectomy and positive surgical margins: relationship with prostate cancer outcome. , 2014, International braz j urol : official journal of the Brazilian Society of Urology.

[14]  Markus Graefen,et al.  Positive surgical margins after radical prostatectomy: a systematic review and contemporary update. , 2014, European urology.

[15]  J. Eastham,et al.  Radical prostatectomy: positive surgical margins matter. , 2013, Urologic oncology.

[16]  Charles A Enke,et al.  Featured Updates to the NCCN Guidelines , 2013 .

[17]  I. Gill,et al.  The effect of prostate weight on the outcomes of laparoscopic radical prostatectomy , 2008, BJU international.

[18]  H. Lepor,et al.  Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy. , 2003, Urology.

[19]  D. Wood,et al.  Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. , 2002, The Journal of urology.

[20]  L. Lacombe,et al.  Duration of neoadjuvant androgen deprivation therapy before radical prostatectomy and disease-free survival in men with prostate cancer. , 2001, Urology.

[21]  J. Sánchez Rodríguez,et al.  [Effect of complete androgen block before radical prostatectomy for cancer of the prostate]. , 1997, Archivos espanoles de urologia.

[22]  R. Montironi,et al.  Effects of neoadjuvant androgen deprivation therapy on prostatic cancer. , 1996, European urology.