Mp14-16 Does the Type of Androgen Deprivation Therapy Has an Impact on Pathohistology and Oncological Outcome for Cytoreductive Radical Prostatectomy (Crp)?

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) II (MP14)1 May 2024MP14-16 DOES THE TYPE OF ANDROGEN DEPRIVATION THERAPY HAS AN IMPACT ON PATHOHISTOLOGY AND ONCOLOGICAL OUTCOME FOR CYTOREDUCTIVE RADICAL PROSTATECTOMY (CRP)? Axel A. Heidenreich, Constantin Rieger, Christian Bach, and David Pfister Axel A. HeidenreichAxel A. Heidenreich , Constantin RiegerConstantin Rieger , Christian BachChristian Bach , and David PfisterDavid Pfister View All Author Informationhttps://doi.org/10.1097/01.JU.0001009428.69695.82.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: cRP has emerged as an alternative treatment option to radiation therapy in men with low risk metastatic hormone sensitive prostate cancer (mHSPC). It was the purpose of our analysis to evaluate if different combinations of androgen deprivation therapy have an impact on pathohistological findings and oncological outcome in men undergoing cRP. METHODS: We performed a retrospective analysis of 91 patients who underwent cRP and pelvic lymph node dissection for low volume mHSPC. Prior to cRP, all patients underwent at least 6 months of neoadjuvant systemic therapy with ADT (n=15, 18.5%), ADT+Abi (n=26, 24.7%), ADT+Apalutamide (n=24, 24.7%), ADT+enzalutamide (n=10, 9.9%), ADT+docetaxel (n=18, 22.2%). We analyzed pathohistology of the cRP and lymphadenectomy specimens and we assessed cancer specific survival (CSS), progression-free survival (PFS), metastatic PFS and overall survival (OS). In addition, surgery related complications and continence were assessed. RESULTS: Mean age was 63 (45-76) years. Median follow-up was 62.1 (2-186) months. Median initial PSA and median preoperative PSA was 110 (25-465) ng/ml and 1.25 (<0.01-5.6) ng/ml, resp. Pathohistology of the total group revealed pT0 in 4 (4.4%) pts and pT2a-c, pT3a/b in 14(15.4%) and 73 (80.2%), resp. Pathohistology depending on the type of ADT is given in Table 1 pN+ was observed in 42 (45.2%) patients with 1-19 positive lymph nodes. Local recurrence was observed in 2/91 (2.2%) pts. We observed Clavien-Dindo grade III-IV complications in 15 (16.1%) patients. With regard to continence, no, mild (1-2 pads/day) or severe incontinence was observed in 67.7%, 18.2%, and 14.1%, resp. OS, mPFS and CSS will be reported. CONCLUSIONS: Based on our data, 75% of patients demonstrate viable and significant PCA despite optimal PSA response to combined neoadjuvant ADT making this a strong argument for local surgical treatment in well selected patients with mHSPC. ADT/apalutamide and ADT/docetaxel are associated with the lowest risk of lymph node metastases making this the preferrable combination. Surgery related side effects are low if cRP is performed in experienced hands. cRP should be discussed as one option of local treatment in multidisciplinary tumor boards. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e226 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Axel A. Heidenreich More articles by this author Constantin Rieger More articles by this author Christian Bach More articles by this author David Pfister More articles by this author Expand All Advertisement PDF downloadLoading ...