Radical Prostatectomy and Perioperative Hormonal Therapy in High-Risk Localized Prostate Cancer Asian Patients

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Purpose To describe the real-world clinical characteristics and treatment patterns of high-risk localized prostate cancer (HR LPC) patients treated with radical prostatectomy (RP) and perioperative hormonal therapy (HT) in Japan, South Korea, and Taiwan Methods A retrospective observational study was conducted, utilizing data from chart review in Japan and from electronic medical records in South Korea and Taiwan (SK+T). Adults newly diagnosed with prostate cancer between January 2015 and June 2017, had one high-risk feature per NCCN guidelines, and received RP and perioperative HT were eligible. Data for Japan were reported separately from SK+T. Results There were 354 and 677 newly diagnosed HR LPC patients in Japan and in SK+T, respectively. Of these patients, 72.6% in Japan and 72.4% in SK+T received RP. A total of 72 (20.3%) HR LPC patients in Japan and 33 (4.9%) HR LPC patients in SK+T who received RP and perioperative HT were eligible for this study. In the Japan cohort, 95.8% of patients received neoadjuvant HT with a median duration of 7.1 months. In the SK+T cohort, 93.9% of patients received adjuvant HT with a median duration of 11.2 months. Negative tumor margins were observed in 87.5% and 45.5% of patients in the Japan and SK+T cohorts, respectively. Among patients who received neoadjuvant HT in the Japan cohort, 33.8% achieved pathologic complete response. Conclusion The proportion of HR LPC patients receiving RP was similar within developed countries in Asia, but the use of perioperative HT varied. Evidence-based strategies are needed to ensure optimal management of HR LPC patients.