Neoadjuvant Chemohormonal Therapy Before Radical Prostatectomy for High-Risk Prostate Cancer

Background

Radical prostatectomy (RP) is the standard treatment for high-risk prostate cancer (PCa), but recurrence rates are high. This study evaluated the feasibility and safety of neoadjuvant chemohormonal therapy (NCHT) before RP for Japanese patients with high-risk localized PCa.

Methods

From February 2009 to April 2016, 21 high-risk patients were enrolled in this prospective study. Patients were treated with docetaxel (70 mg/m2) every four weeks for three cycles and luteinizing hormone-releasing hormone agonist. Dose reductions were applied for grade 3–4 toxicities.

Results

The median follow-up was 88.6 months. The dose of docetaxel was reduced in 13 patients. The estimated five-year biochemical progression-free survival (bPFS) rate was 57.1%. There was a significant difference in bPFS between the nVHR and VHR groups (p = 0.023), with five-year bPFS rates of 76.9% and 25.0%, respectively.

Conclusions

NCHT was found to be safe and feasible, with a better bPFS rate observed in the nVHR group. However, NCHT was not acceptable to improve bPFS in patients with VHR PCa, indicating the need for additional treatment modalities to improve outcomes in VHR patients.

Keywords

prostate cancer, neoadjuvant chemohormonal therapy, radical prostatectomy