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Overall survival of high-risk prostate cancer patients who received neoadjuvant chemohormonal therapy followed by radical prostatectomy at a single institution

Abstract

Background

The optimal treatment for high-risk prostate cancer (PCa) remains to be established. We previously reported favorable, biochemical recurrence-free survival in high-risk PCa patients treated with a neoadjuvant gonadotropin-releasing hormone agonist or antagonist and estramustine phosphate (EMP) (chemohormonal therapy; CHT) followed by radical prostatectomy (RP). We conducted a retrospective study to elucidate the clinical benefit of neoadjuvant CHT for high-risk PCa patients.

Methods

We reviewed the clinical and pathological records of 1254 PCa patients who underwent RP and bilateral pelvic lymphadenectomy between July 1996 and April 2016 at Hirosaki University. According to the D’Amico risk classification, we focused on 613 patients in the high-risk group. The high-risk PCa patients were further divided into two groups based on whether the patients received neoadjuvant CHT before RP (EMP group) or not (non-EMP group). The endpoint was overall survival (OS) after surgery.

Results

The 5- and 10-year OS rates were 98.5 and 92.6%, respectively. The 10-year OS rate in the EMP group was significantly higher compared to the non-EMP group (P = 0.021). In multivariate analysis, administration of neoadjuvant CHT, lymph node involvement, and castration-resistant PCa status were significantly associated with OS.

Conclusions

RP with neoadjuvant CHT using EMP for high-risk PCa patients provided excellent long-term OS.

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Acknowledgements

This study was supported by the Grants-in-aid for Scientific Research from the Japan Society for the Promotion of Science (15H02563) (to CO), (15K15579) (to CO) and (17K11118) (to TK).

Author information

Correspondence to Takuya Koie.

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No author has any conflict of interest.

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Fujita, N., Koie, T., Ohyama, C. et al. Overall survival of high-risk prostate cancer patients who received neoadjuvant chemohormonal therapy followed by radical prostatectomy at a single institution. Int J Clin Oncol 22, 1087–1093 (2017). https://doi.org/10.1007/s10147-017-1160-8

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Keywords

  • Prostate cancer
  • Radical prostatectomy
  • Neoadjuvant chemohormonal therapy
  • Estramustine phosphate
  • Overall survival