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Open Access Research article

Neoadjuvant hormonal therapy is a feasible option in laparoscopic radical prostatectomy

Taku Naiki1, Noriyasu Kawai1*, Takehiko Okamura3, Daisuke Nagata2, Yoshiyuki Kojima1, Hidetoshi Akita3, Takahiro Yasui1, Keiichi Tozawa1 and Kenjiro Kohri1

Author Affiliations

1 Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan

2 Department of Urology, East Medical Center Higashi Municipal Hospital City of Nagoya, Nagoya, Japan

3 Department of Urology, Anjo Kosei Hospital, Anjo, Japan

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BMC Urology 2012, 12:36  doi:10.1186/1471-2490-12-36

Published: 18 December 2012

Abstract

Background

Few reports can be found in the literature with respect to the impact of neoadjuvant hormonal therapy (NHT) on operative parameters on laparoscopic radical prostatectomy (LRP) in a large study. The aim of this study was to evaluate the safety and efficacy of NHT prior to LRP for locally confined prostate cancer.

Methods

From January 2004 to September 2009, 342 patients undergoing LRP were analyzed, specifically comparing 72 patients who received NHT to 270 who did not. All patients were in clinical stage T2 and nerve sparing LRP were not included.

Results

The mean patient age, preoperative prostate specific antigen (PSA), clinical stage, and biopsy Gleason grade were similar for the NHT and the non-NHT LRP groups. The median blood loss and the median operative time were also similar. There were no differences in the intraoperative complication rate of rectum injury, blood transfusion, and open surgery conversion. The positive surgical margin rate was significantly improved in NHT patients. Moreover, PSA recurrence within two years was significantly less in long-term NHT than in non-NHT patients.

Conclusions

LRP was shown as a safe and efficacious procedure in patients who have received NHT. Perioperative morbidity of NHT patients undergoing LRP appears equivalent to non-NHT patients, with lower positive surgical margin, and PSA recurrence rate.

Keywords:
Prostate cancer; Neoadjuvant hormonal therapy; Laparoscopic radical prostatectomy