The comparison of outcomes between neoadjuvant novel and classical hormonal therapy in patients with locally advanced prostate cancer: a retrospective study.
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引用次数: 0
Abstract
Objective: This study aimed to compare the outcomes of neoadjuvant novel hormonal therapy (NHT) versus classical hormonal therapy (CHT) before radical prostatectomy (RP) in patients with locally advanced prostate cancer.
Methods: Propensity score matching (2:1) was performed to minimize the effect of confounders at our center. We retrospectively analyzed 99 patients who received neoadjuvant hormonal therapy for 3-6 months from March 2019 to April 2023. The novel hormonal agents included apalutamide, darolutamide, or enzalutamide, whereas the classical hormonal agent was bicalutamide. The primary endpoint was pathological response. Secondary outcomes included prostate specific antigen (PSA) complete response rate, biochemical recurrence-free survival (bRFS), and biochemical response rate.
Results: After propensity score matching, 63 patients were matched to the CHT group and 36 patients were matched to the NHT group. All patients received androgen deprivation therapy. Pathological response Group 0 was not observed in either group; 41.3% (26/63) of patients in the CHT group achieved a complete response (Group 1), compared with 52.8% (19/36) in the NHT group. Neoadjuvant NHT showed significant advantages over CHT in reducing prostate volume (p < 0.001), downstaging (p = 0.012), and the PSA complete response rate (p = 0.002). PSA complete response was an independent predictor for complete response (OR 2.8, 95%CI 1.14-6.88, p = 0.025). Neoadjuvant NHT also demonstrated a significant improvement in bRFS compared with CHT, and there was a 70% lower risk of biochemical recurrence in the NHT group (HR 0.3, 95% CI 0.17-0.55, p = 0.0006).
Conclusion: Neoadjuvant NHT resulted in superior pathological responses and PSA responses compared with neoadjuvant CHT in patients with locally advanced prostate cancer. Lower PSA values prior to RP were associated with complete response. Our findings highlighted a significant benefit of neoadjuvant NHT in improving bRFS.
期刊介绍：
BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The journal considers manuscripts in the following broad subject-specific sections of urology:
Endourology and technology
Epidemiology and health outcomes
Pediatric urology
Pre-clinical and basic research
Reconstructive urology
Sexual function and fertility
Urological imaging
Urological oncology
Voiding dysfunction
Case reports.
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