Key result
Neoadjuvant androgen deprivation therapy prior to radical prostatectomy significantly reduced operative time (185 vs 195 mins) and estimated blood loss (300 vs 500 mL) compared to no NADT.
Why the study?
The study was conducted to demonstrate the efficacy of neoadjuvant androgen deprivation therapy on perioperative outcomes in patients undergoing radical prostatectomy.
Does neoadjuvant androgen deprivation therapy improve perioperative outcomes in patients with clinically localized prostate cancer undergoing radical prostatectomy?
Cohort (n=718)
No
Does neoadjuvant androgen deprivation therapy improve perioperative outcomes in patients with clinically localized prostate cancer undergoing radical prostatectomy?
Absolute Event Rate: 185% vs 195%
Neoadjuvant androgen deprivation therapy prior to radical prostatectomy significantly improves perioperative outcomes such as operative time and blood loss, particularly in non-low risk prostate cancer.
NADT was associated with better perioperative outcomes in RP, especially non-low-risk cases; leaves open need for RCTs before practice change.
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 non-NADT. 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 non-low risk prostate cancer, and has comparable pathological outcomes.
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Sangkum et al. (2021) conducted a cohort in Clinically localized prostate cancer (n=718). Neoadjuvant androgen deprivation therapy (NADT) vs. No neoadjuvant ADT (non-NADT) was evaluated on Operative time (minutes). Neoadjuvant androgen deprivation therapy prior to radical prostatectomy significantly reduced operative time (185 vs 195 mins) and estimated blood loss (300 vs 500 mL) compared to no NADT.
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