Mp60-13 Evaluating Neoadjuvant Hormone Therapy in Locally Advanced Prostate Cancer: Clinical and Pathological Outcomes

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-13 EVALUATING NEOADJUVANT HORMONE THERAPY IN LOCALLY ADVANCED PROSTATE CANCER: CLINICAL AND PATHOLOGICAL OUTCOMES S. K. Raghunath, Gowtham Krishna Penmetsa, Kinju Adhikari, Ravi Taori, Deepak Krishnappa, and Ali Abbas S. K. RaghunathS. K. Raghunath , Gowtham Krishna PenmetsaGowtham Krishna Penmetsa , Kinju AdhikariKinju Adhikari , Ravi TaoriRavi Taori , Deepak KrishnappaDeepak Krishnappa , and Ali AbbasAli Abbas View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Locally advanced prostate cancer has traditionally been managed with a combination of radiation therapy and hormone therapy. This retrospective study aimed to assess the outcomes of intense neoadjuvant Hormone Therapy (iNAHT) for Locally Advanced Prostate Cancer (LAPC), focusing on surgical feasibility and both pathological and clinical outcomes. METHODS: A retrospective analysis was conducted on 136 patients who underwent iNAHT using Injection Degarelix and Tablet Abiraterone (1000mg) with wysolone for a period of six months, followed by re assessment with mpMRI pelvis and RARP+B/L PLND from February 2016 to June 2023. Parameters evaluated included the reduction in tumor stage in HPE, changes in PSA levels, margin status, surgical complications, continence rate, pathological complete resolution (pCR), minimal residual disease (mRD), and Biochemical Recurrence (BCR). RESULTS: Among the 136 patients diagnosed with Locally Advanced Prostate Cancer (cT3b/T4, N0/N1) who received neoadjuvant Hormone Therapy (iNAHT) with Injection Degarelix in combination with Tablet Abiraterone for six months prior to surgery, all patients experienced a reduction in Serum PSA levels to less than 0.5 ng/ml. The average PSA level for the 136 patients was 32 ng/ml. Significantly, 68% of cases showed an average stage reduction to pT2 upon histopathological examination, compared to their initial stages of cT3b and T4. 8% exhibited positive surgical margins. There was only one case that experienced a rectal injury, which was promptly managed intraoperatively. pCR was achieved in two cases, while mRD was observed in 24 cases (18%). After an average follow-up period of 3.5 years, 45 cases displayed BCR, whereas 91 cases remained free of BCR and did not necessitate adjuvant therapy. The latter group of 91 patients had an average follow-up of over 2 years. Four cases progressed to metastatic disease, and two cases developed CRPC. No cancer-specific mortality among the 136 patients. Regarding urinary continence, at the time of catheter removal, 23% of patients were continent, which increased to 65% at 3 months, 92% at 6 months, and 97% at 1 year. CONCLUSIONS: This retrospective study suggests that intense neoadjuvant Hormone Therapy, in combination with surgical intervention, demonstrates promising results for patients with Locally Advanced Prostate Cancer. It offers substantial reductions in serum PSA levels, favorable pathological stage reductions, and a low incidence of surgical complications. Furthermore, the findings indicate that a subset of patients achieved complete resolution or minimal residual disease, leading to extended periods without biochemical recurrence. Source of Funding: Self © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1005 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information S. K. Raghunath More articles by this author Gowtham Krishna Penmetsa More articles by this author Kinju Adhikari More articles by this author Ravi Taori More articles by this author Deepak Krishnappa More articles by this author Ali Abbas More articles by this author Expand All Advertisement PDF downloadLoading ...