Frontiers in oncology · 2026
Efficacy of neoadjuvant hormonal therapy combined with robot-assisted radical prostatectomy for oligometastatic prostate cancer: a multicenter retrospective study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dong Yujie, Li Zhuoran, Chen Zhiqiang, Tian Zhen, Chen Weilin, Hu Jieping, Jia Yuqi, Luo Jin, Zou Nanxin, Li Jinqiao, Liu Qiwei, Yang Qiming, Wang Chao, Xu Xiaofeng, Fu Bin, Zhang Xu, Wang Baojun
Аннотация
OBJECTIVE: To evaluate the efficacy of neoadjuvant hormonal therapy (NHT) on perioperative and oncological outcomes in patients with oligometastatic prostate cancer (OmPCa) treated with robot-assisted radical prostatectomy (RARP) and adjuvant androgen-deprivation therapy (ADT).
METHODS: In this multicenter retrospective study, 160 OmPCa patients treated from five Chinese medical centers between May 2010 and May 2023 were included: 80 received NHT followed by RARP+ADT, and 80 underwent RARP+ADT alone. We evaluated surgical information, pathological findings, biochemical progression-free survival (bPFS), radiological progression-free survival (rPFS), overall survival (OS), subsequent treatments, and ADT-related adverse events.
RESULTS: Compared to the standard therapy (ST) group, the NHT group exhibited shorter operative time (170 vs. 200min; P = 0.030), less blood loss (100 vs. 200 mL; P = 0.022), lower positive surgical margin rate (17.50% vs. 37.50%; P = 0.005), and higher rates of pathological downstaging in T-stage (48.8% vs. 6.3%; P<0.001). More NHT patients achieved undetectable PSA (83.8% vs. 65.0%; P = 0.007) with a shorter time to PSA nadir (2 vs. 3 months; P = 0.002). After a median postoperative follow-up of 52 months, no significant differences were observed in bPFS, rPFS or OS between groups. However, subgroup analysis revealed significant interaction effects between NHT and biopsy Gleason score ≥8, seminal vesicle invasion, and clinical T stage ≥ T3 (all P-interaction<0.05), with these subgroups showing significantly improved bPFS, rPFS and OS. Furthermore, patients in the NHT group received fewer subsequent treatments (32.5% vs. 47.5%, P = 0.031), and the incidence of ADT-related adverse events was comparable between the two groups (all P >0.05).
CONCLUSION: NHT improves perioperative outcomes and reduces the need for subsequent salvage therapies in OmPCa patients undergoing RARP. It may offer oncological benefits, particularly those with a biopsy Gleason score ≥8 or clinical T-stage≥T3. It represents a safe and feasible neoadjuvant approach.
METHODS: In this multicenter retrospective study, 160 OmPCa patients treated from five Chinese medical centers between May 2010 and May 2023 were included: 80 received NHT followed by RARP+ADT, and 80 underwent RARP+ADT alone. We evaluated surgical information, pathological findings, biochemical progression-free survival (bPFS), radiological progression-free survival (rPFS), overall survival (OS), subsequent treatments, and ADT-related adverse events.
RESULTS: Compared to the standard therapy (ST) group, the NHT group exhibited shorter operative time (170 vs. 200min; P = 0.030), less blood loss (100 vs. 200 mL; P = 0.022), lower positive surgical margin rate (17.50% vs. 37.50%; P = 0.005), and higher rates of pathological downstaging in T-stage (48.8% vs. 6.3%; P<0.001). More NHT patients achieved undetectable PSA (83.8% vs. 65.0%; P = 0.007) with a shorter time to PSA nadir (2 vs. 3 months; P = 0.002). After a median postoperative follow-up of 52 months, no significant differences were observed in bPFS, rPFS or OS between groups. However, subgroup analysis revealed significant interaction effects between NHT and biopsy Gleason score ≥8, seminal vesicle invasion, and clinical T stage ≥ T3 (all P-interaction<0.05), with these subgroups showing significantly improved bPFS, rPFS and OS. Furthermore, patients in the NHT group received fewer subsequent treatments (32.5% vs. 47.5%, P = 0.031), and the incidence of ADT-related adverse events was comparable between the two groups (all P >0.05).
CONCLUSION: NHT improves perioperative outcomes and reduces the need for subsequent salvage therapies in OmPCa patients undergoing RARP. It may offer oncological benefits, particularly those with a biopsy Gleason score ≥8 or clinical T-stage≥T3. It represents a safe and feasible neoadjuvant approach.