Randomized, Prospective, Controlled Study Comparing Radical Prostatectomy Alone and Neoadjuvant Androgen Withdrawal in the Treatment of Localized Prostate Cancer

No AccessJournal of UrologyClinical Urology: Original Article1 Sep 1996Randomized, Prospective, Controlled Study Comparing Radical Prostatectomy Alone and Neoadjuvant Androgen Withdrawal in the Treatment of Localized Prostate Cancer S. Larry Goldenberg, Laurence H. Klotz, John Srigley, Michael A.S. Jewett, David Mador, Yves Fradet, Jack Barkin, Joseph Chin, Jean-Marie Paquin, Martin J. Bullock, and Suzanne Laplante S. Larry GoldenbergS. Larry Goldenberg , Laurence H. KlotzLaurence H. Klotz , John SrigleyJohn Srigley , Michael A.S. JewettMichael A.S. Jewett , David MadorDavid Mador , Yves FradetYves Fradet , Jack BarkinJack Barkin , Joseph ChinJoseph Chin , Jean-Marie PaquinJean-Marie Paquin , Martin J. BullockMartin J. Bullock , and Suzanne LaplanteSuzanne Laplante View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65645-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A prospective, multicenter, randomized study was done to test the hypothesis that neoadjuvant androgen withdrawal decreases the incidence of positive margins following radical prostatectomy for localized prostate cancer. Materials and Methods: Observations were made of 213 patients randomized to undergo radical prostatectomy alone (101) or to receive a 12-week course of 300 mg. cyproterone acetate daily followed by surgery (112). Groups were similar at baseline in terms of clinical stage, serum prostate specific antigen and Gleason score. Of 192 patients available for efficacy analysis 9 had stage T1b, 8 stage T1c, 63 stage T2a, 36 stage T2b and 76 stage T2c disease. Results: One or more positive surgical margins were found in 59 of 91 patients (64.8 percent) in the surgery only group compared to 28 of 101 (27.7 percent) in the cyproterone acetate group (p = 0.001). Patients who received preoperative therapy had a statistically significantly lower rate of apical margin involvement than those who did not (17.8 versus 47.8 percent, respectively, p less than 0.0001). There was no statistically significant difference in surgical (p = 0.8645) or postoperative (p = 0.173) complications between the 2 groups. Conclusions: Neoadjuvant androgen withdrawal with a 12-week course of 300 mg. cyproterone acetate daily results in a lower rate of positive margins without adversely affecting postoperative recovery. The impact on patient survival will be determined by long-term followup. References 1 : Frequency and location of extracapsular extension and positive surgical margins in radical prostatectomy specimens. J. Urol.1992; 148: 331. 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Link, Google Scholar From the Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byChi K, Chin J, Winquist E, Klotz L, Saad F and Gleave M (2008) Multicenter Phase II Study of Combined Neoadjuvant Docetaxel and Hormone Therapy Before Radical Prostatectomy for Patients With High Risk Localized Prostate CancerJournal of Urology, VOL. 180, NO. 2, (565-570), Online publication date: 1-Aug-2008.Thompson I, Thrasher J, Aus G, Burnett A, Canby-Hagino E, Cookson M, D'Amico A, Dmochowski R, Eton D, Forman J, Goldenberg S, Hernandez J, Higano C, Kraus S, Moul J and Tangen C (2018) Guideline for the Management of Clinically Localized Prostate Cancer: 2007 UpdateJournal of Urology, VOL. 177, NO. 6, (2106-2131), Online publication date: 1-Jun-2007.Maldonado-Valadez R, Teber D, Erdogru T, Safi K, Frede T and Rassweiler J (2018) The Impact of Neoadjuvant Hormonal Therapy on the Outcome of Laparoscopic Radical Prostatectomy: A Matched Pair AnalysisJournal of Urology, VOL. 175, NO. 6, (2092-2096), Online publication date: 1-Jun-2006.KONETY B, EASTHAM J, REUTER V, SCARDINO P, DONAT S, DALBAGNI G, RUSSO P, HERR H, SCHWARTZ L, KANTOFF P, SCHER H and KELLY W (2018) Feasibility of Radical Prostatectomy After Neoadjuvant Chemohormonal Therapy for Patients With High Risk or Locally Advanced Prostate Cancer: Results of a Phase I/II StudyJournal of Urology, VOL. 171, NO. 2, (709-713), Online publication date: 1-Feb-2004.KLOTZ L, GOLDENBERG S, JEWETT M, FRADET Y, NAM R, BARKIN J, CHIN J and CHATTERJEE S (2018) Long-term Followup of a Randomized Trial of 0 Versus 3 Months of Neoadjuvant Androgen Ablation Before Radical ProstatectomyJournal of Urology, VOL. 170, NO. 3, (791-794), Online publication date: 1-Sep-2003.GLEAVE M, GOLDENBERG S, CHIN J, WARNER J, SAAD F, KLOTZ L, JEWETT M, KASSABIAN V, CHETNER M, DUPONT C and VAN RENSSELAER S (2018) RANDOMIZED COMPARATIVE STUDY OF 3 VERSUS 8-MONTH NEOADJUVANT HORMONAL THERAPY BEFORE RADICAL PROSTATECTOMY: BIOCHEMICAL AND PATHOLOGICAL EFFECTSJournal of Urology, VOL. 166, NO. 2, (500-507), Online publication date: 1-Aug-2001.SCOLIERI M, ALTMAN A and RESNICK M (2018) NEOADJUVANT HORMONAL ABLATIVE THERAPY BEFORE RADICAL PROSTATECTOMY: A REVIEW. 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Volume 156Issue 3September 1996Page: 873-877 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information S. Larry Goldenberg More articles by this author Laurence H. Klotz More articles by this author John Srigley More articles by this author Michael A.S. Jewett More articles by this author David Mador More articles by this author Yves Fradet More articles by this author Jack Barkin More articles by this author Joseph Chin More articles by this author Jean-Marie Paquin More articles by this author Martin J. Bullock More articles by this author Suzanne Laplante More articles by this author Expand All Advertisement PDF downloadLoading ...