Research and Reports in Urology (Jun 2021)

Neoadjuvant Androgen Deprivation Therapy Effects on Perioperative Outcomes Prior to Radical Prostatectomy: Eleven Years of Experiences at Ramathibodi Hospital

  • Sangkum P,
  • Sirisopana K,
  • Jenjitranant P,
  • Kijvikai K,
  • Pacharatakul S,
  • Leenanupunth C,
  • Kochakarn W,
  • Kongchareonsombat W

Journal volume & issue
Vol. Volume 13
pp. 303 – 312

Abstract

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Premsant Sangkum,1 Kun Sirisopana,1 Pocharapong Jenjitranant,1 Kittinut Kijvikai,1 Suthep Pacharatakul,2 Charoen Leenanupunth,1 Wachira Kochakarn,1 Wisoot Kongchareonsombat1 1Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Urology, Department of Surgery, Police Hospital, Bangkok, ThailandCorrespondence: Wisoot KongchareonsombatDivision of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandTel +66-2-2011536Fax +66-89-8112436Email [email protected]: 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.Keywords: prostate cancer, neoadjuvant androgen deprivation therapy, radical prostatectomy, laparoscopy, robot-assisted laparoscopic surgery, open surgery, perioperative outcome

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