Abstract
BackgroundTo assess the outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with a high risk of localized prostate cancer (PCa).MethodsComplete androgen blockade followed by 6 cycles of docetaxel (30 mg/m2) with estramustine phosphate (560 mg) were given to 18 PCa patients before radical prostatectomy. Subsequently, the clinical and pathological outcomes were analyzed.ResultsNo patients had severe adverse events during chemohormonal therapy, and hence they were treated with radical prostatectomy. Two patients (11.1%) achieved pathological complete response. Surgical margins were negative in all patients. At a median follow-up of 18 months, 14 patients (77.8%) were disease-free without PSA recurrence. All 4 patients with PSA recurrence had pathologic T3b or T4 disease and 3 of these 4 patients had pathologic N1 disease.ConclusionWe found that neoadjuvant chemohormonal therapy with complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy was safe, feasible, and associated with favorable pathological outcomes in patients with a high risk of localized PCa.
Highlights
To assess the outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with a high risk of localized prostate cancer (PCa)
In this study, we elucidated the efficacy of the combination of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate after radical prostatectomy in patients with high-risk of localized PCa
Only 2 studies have reported the outcome of neoadjuvant chemohormonal therapy using a combination of androgen deprivation followed by treatment with docetaxel and estramustine phosphate [12]
Summary
To assess the outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with a high risk of localized prostate cancer (PCa). Methods: Complete androgen blockade followed by 6 cycles of docetaxel (30 mg/m2) with estramustine phosphate (560 mg) were given to 18 PCa patients before radical prostatectomy. Men with high-risk localized PCa [as defined by the parameters including serum prostate-specific antigen (PSA) levels, clinical stage, and histological grade] have a significantly higher possibility of biochemical relapse than the control groups [3,4]. To improve the outcome of local therapy, several groups conducted neoadjuvant hormonal therapy before radical prostatectomy. A recent systematic review and meta-analysis showed that neoadjuvant hormone therapy before prostatectomy does not improve the overall survival and diseasefree survival, while it does improve the pathological outcome [5]
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