The survival impact of neoadjuvant hormonal therapy before radical prostatectomy for treatment of high-risk prostate cancer

L Tosco, A Laenen, A Briganti, P Gontero, RJ Karnes, M Albersen, PJ Bastian, P Chlosta, F Claessens, FK Chun, W Everaerts, C Gratzke, M Graefen, B Kneitz, G Marchioro, RS Salas, B Tombal, T Van Den Broeck, L Moris, A BattagliaH Van Der Poel, J Walz, A Bossi, G De Meerleer, K Haustermans, H Van Poppel, M Spahn, SS Joniau, for the European Multicenter Prostate Cancer Clinical, Translational Research Group (EMPaCT)

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Abstract

BACKGROUND: Several randomized controlled trials assessed the outcomes of patients treated with neoadjuvant hormonal therapy (NHT) before radical prostatectomy (RP). The majority of them included mainly low and intermediate risk prostate cancer (PCa) without specifically assessing PCa-related death (PCRD). Thus, there is a lack of knowledge regarding a possible effect of NHT on PCRD in the high-risk PCa population. We aimed to analyze the effect of NHT on PCRD in a multicenter high-risk PCa population treated with RP, using a propensity-score adjustment. METHODS: This is a retrospective multi-institutional study including patients with high-risk PCa defined as: clinical stage T3-4, PSA >20 ng ml-1 or biopsy Gleason score 8-10. We compared PCRD between RP and NHT+RP using competing risks analysis. Correction for group differences was performed by propensity-score adjustment. RESULTS: After application of the inclusion/exclusion criteria, 1573 patients remained for analysis; 1170 patients received RP and 403 NHT+RP. Median follow-up was 56 months (interquartile range 29-88). Eighty-six patients died of PCa and 106 of other causes. NHT decreased the risk of PCRD (hazard ratio (HR) 0.5; 95% confidence interval (CI) 0.32-0.80; P=0.0014). An interaction effect between NHT and radiotherapy (RT) was observed (HR 0.3; 95% CI 0.21-0.43; P
Original languageEnglish
Pages (from-to)407-412
Number of pages6
JournalProstate Cancer and Prostatic Diseases
Volume20
Issue number4
DOIs
Publication statusPublished - 2017

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Neoadjuvant Therapy
Prostatectomy
Prostatic Neoplasms
Survival
Propensity Score
Therapeutics
Confidence Intervals
Neoplasm Grading
Population
Radiotherapy
Randomized Controlled Trials
Biopsy

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The survival impact of neoadjuvant hormonal therapy before radical prostatectomy for treatment of high-risk prostate cancer. / Tosco, L; Laenen, A; Briganti, A; Gontero, P; Karnes, RJ; Albersen, M; Bastian, PJ; Chlosta, P; Claessens, F; Chun, FK; Everaerts, W; Gratzke, C; Graefen, M; Kneitz, B; Marchioro, G; Salas, RS; Tombal, B; Van Den Broeck, T; Moris, L; Battaglia, A; Van Der Poel, H; Walz, J; Bossi, A; De Meerleer, G; Haustermans, K; Van Poppel, H; Spahn, M; Joniau, SS; Clinical, for the European Multicenter Prostate Cancer; (EMPaCT), Translational Research Group.

In: Prostate Cancer and Prostatic Diseases, Vol. 20, No. 4, 2017, p. 407-412.

Research output: Contribution to journalArticle

Tosco, L, Laenen, A, Briganti, A, Gontero, P, Karnes, RJ, Albersen, M, Bastian, PJ, Chlosta, P, Claessens, F, Chun, FK, Everaerts, W, Gratzke, C, Graefen, M, Kneitz, B, Marchioro, G, Salas, RS, Tombal, B, Van Den Broeck, T, Moris, L, Battaglia, A, Van Der Poel, H, Walz, J, Bossi, A, De Meerleer, G, Haustermans, K, Van Poppel, H, Spahn, M, Joniau, SS, Clinical, FTEMPC & (EMPaCT), TRG 2017, 'The survival impact of neoadjuvant hormonal therapy before radical prostatectomy for treatment of high-risk prostate cancer', Prostate Cancer and Prostatic Diseases, vol. 20, no. 4, pp. 407-412. https://doi.org/10.1038/pcan.2017.29
Tosco, L ; Laenen, A ; Briganti, A ; Gontero, P ; Karnes, RJ ; Albersen, M ; Bastian, PJ ; Chlosta, P ; Claessens, F ; Chun, FK ; Everaerts, W ; Gratzke, C ; Graefen, M ; Kneitz, B ; Marchioro, G ; Salas, RS ; Tombal, B ; Van Den Broeck, T ; Moris, L ; Battaglia, A ; Van Der Poel, H ; Walz, J ; Bossi, A ; De Meerleer, G ; Haustermans, K ; Van Poppel, H ; Spahn, M ; Joniau, SS ; Clinical, for the European Multicenter Prostate Cancer ; (EMPaCT), Translational Research Group. / The survival impact of neoadjuvant hormonal therapy before radical prostatectomy for treatment of high-risk prostate cancer. In: Prostate Cancer and Prostatic Diseases. 2017 ; Vol. 20, No. 4. pp. 407-412.
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T1 - The survival impact of neoadjuvant hormonal therapy before radical prostatectomy for treatment of high-risk prostate cancer

AU - Tosco, L

AU - Laenen, A

AU - Briganti, A

AU - Gontero, P

AU - Karnes, RJ

AU - Albersen, M

AU - Bastian, PJ

AU - Chlosta, P

AU - Claessens, F

AU - Chun, FK

AU - Everaerts, W

AU - Gratzke, C

AU - Graefen, M

AU - Kneitz, B

AU - Marchioro, G

AU - Salas, RS

AU - Tombal, B

AU - Van Den Broeck, T

AU - Moris, L

AU - Battaglia, A

AU - Van Der Poel, H

AU - Walz, J

AU - Bossi, A

AU - De Meerleer, G

AU - Haustermans, K

AU - Van Poppel, H

AU - Spahn, M

AU - Joniau, SS

AU - Clinical, for the European Multicenter Prostate Cancer

AU - (EMPaCT), Translational Research Group

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Several randomized controlled trials assessed the outcomes of patients treated with neoadjuvant hormonal therapy (NHT) before radical prostatectomy (RP). The majority of them included mainly low and intermediate risk prostate cancer (PCa) without specifically assessing PCa-related death (PCRD). Thus, there is a lack of knowledge regarding a possible effect of NHT on PCRD in the high-risk PCa population. We aimed to analyze the effect of NHT on PCRD in a multicenter high-risk PCa population treated with RP, using a propensity-score adjustment. METHODS: This is a retrospective multi-institutional study including patients with high-risk PCa defined as: clinical stage T3-4, PSA >20 ng ml-1 or biopsy Gleason score 8-10. We compared PCRD between RP and NHT+RP using competing risks analysis. Correction for group differences was performed by propensity-score adjustment. RESULTS: After application of the inclusion/exclusion criteria, 1573 patients remained for analysis; 1170 patients received RP and 403 NHT+RP. Median follow-up was 56 months (interquartile range 29-88). Eighty-six patients died of PCa and 106 of other causes. NHT decreased the risk of PCRD (hazard ratio (HR) 0.5; 95% confidence interval (CI) 0.32-0.80; P=0.0014). An interaction effect between NHT and radiotherapy (RT) was observed (HR 0.3; 95% CI 0.21-0.43; P

AB - BACKGROUND: Several randomized controlled trials assessed the outcomes of patients treated with neoadjuvant hormonal therapy (NHT) before radical prostatectomy (RP). The majority of them included mainly low and intermediate risk prostate cancer (PCa) without specifically assessing PCa-related death (PCRD). Thus, there is a lack of knowledge regarding a possible effect of NHT on PCRD in the high-risk PCa population. We aimed to analyze the effect of NHT on PCRD in a multicenter high-risk PCa population treated with RP, using a propensity-score adjustment. METHODS: This is a retrospective multi-institutional study including patients with high-risk PCa defined as: clinical stage T3-4, PSA >20 ng ml-1 or biopsy Gleason score 8-10. We compared PCRD between RP and NHT+RP using competing risks analysis. Correction for group differences was performed by propensity-score adjustment. RESULTS: After application of the inclusion/exclusion criteria, 1573 patients remained for analysis; 1170 patients received RP and 403 NHT+RP. Median follow-up was 56 months (interquartile range 29-88). Eighty-six patients died of PCa and 106 of other causes. NHT decreased the risk of PCRD (hazard ratio (HR) 0.5; 95% confidence interval (CI) 0.32-0.80; P=0.0014). An interaction effect between NHT and radiotherapy (RT) was observed (HR 0.3; 95% CI 0.21-0.43; P

U2 - 10.1038/pcan.2017.29

DO - 10.1038/pcan.2017.29

M3 - Article

VL - 20

SP - 407

EP - 412

JO - Prostate Cancer and Prostatic Diseases

JF - Prostate Cancer and Prostatic Diseases

SN - 1365-7852

IS - 4

ER -