PDF(Pubmed)
Abstract：
UNASSIGNED: Prostate cancer (PCa) is the most common cancer in men. High-risk PCa is associated with an increased risk of PCa-related death. The combined use of androgen deprivation therapy (ADT) is essential to improve oncological outcomes in patients with high-risk PCa, and relatively long-term ADT administration is preferred when radiotherapy is performed. Meanwhile, whether neoadjuvant therapy for radical prostatectomy (RP) improves oncological outcomes remains controversial. This study aimed to review the oncological outcomes of RP in high-risk PCa and emphasize the significance of neoadjuvant therapy including neoadjuvant hormonal therapy (NHT) and neoadjuvant chemohormonal therapy (NCHT) followed by RP for managing high-risk PCa.
UNASSIGNED: We searched for articles published in the PubMed and Scopus databases from January 1, 2005 to March 30, 2023 using the medical subject headings (MeSH) terms: prostate cancer, prostatectomy, radiation therapy, neoadjuvant therapy, and treatment outcome.
UNASSIGNED: The study on NHT before RP for high-risk PCa found that NHT was associated with reduced adverse pathological features, such as pT3, positive surgical margins (PSM), and lymph node involvement. However, despite shorter operative times and improved surgical outcomes, NHT did not significantly enhance biochemical recurrence (BCR) or other oncological outcomes. The combination therapy using ADT and androgen receptor signaling inhibitors (ARSI) showed varying results. Another investigation explored NCHT with taxane-based agents, indicating acceptable treatment benefits and improved BCR-free survival rates in high-risk PCa patients, demonstrating potential feasibility for this approach. Ongoing trials, like the PROTEUS trial, aim to further evaluate the therapeutic efficacy of neoadjuvant therapy in high-risk PCa.
UNASSIGNED: NHT for high-risk PCa does not contribute to improved oncological outcome and should not be administered easily for downstaging or PSM reduction. NHT in combination with ARSI has the potential advantage of improving the oncological outcome of high-risk PCa compared to RP alone, but the results are currently unsatisfactory, and the development of individualized treatment strategies using several different therapeutic approaches is needed.
UNASSIGNED: We searched for articles published in the PubMed and Scopus databases from January 1, 2005 to March 30, 2023 using the medical subject headings (MeSH) terms: prostate cancer, prostatectomy, radiation therapy, neoadjuvant therapy, and treatment outcome.
UNASSIGNED: The study on NHT before RP for high-risk PCa found that NHT was associated with reduced adverse pathological features, such as pT3, positive surgical margins (PSM), and lymph node involvement. However, despite shorter operative times and improved surgical outcomes, NHT did not significantly enhance biochemical recurrence (BCR) or other oncological outcomes. The combination therapy using ADT and androgen receptor signaling inhibitors (ARSI) showed varying results. Another investigation explored NCHT with taxane-based agents, indicating acceptable treatment benefits and improved BCR-free survival rates in high-risk PCa patients, demonstrating potential feasibility for this approach. Ongoing trials, like the PROTEUS trial, aim to further evaluate the therapeutic efficacy of neoadjuvant therapy in high-risk PCa.
UNASSIGNED: NHT for high-risk PCa does not contribute to improved oncological outcome and should not be administered easily for downstaging or PSM reduction. NHT in combination with ARSI has the potential advantage of improving the oncological outcome of high-risk PCa compared to RP alone, but the results are currently unsatisfactory, and the development of individualized treatment strategies using several different therapeutic approaches is needed.
摘要：
■前列腺癌（PCa）是男性中最常见的癌症。高危PCa与PCa相关死亡风险增加相关。联合使用雄激素剥夺治疗（ADT）对于改善高危PCa患者的肿瘤预后至关重要。当进行放疗时，相对长期的ADT给药是优选的。同时,前列腺癌根治术(RP)的新辅助治疗是否能改善肿瘤预后仍存在争议.本研究旨在回顾RP在高危PCa中的肿瘤学结果，并强调新辅助治疗的重要性，包括新辅助激素治疗（NHT）和新辅助化学激素治疗（NCHT），然后用RP管理高危PCa。
■我们使用医学主题标题（MeSH）术语搜索了2005年1月1日至2023年3月30日在PubMed和Scopus数据库中发表的文章：前列腺癌，前列腺切除术,放射治疗,新辅助治疗,和治疗结果。
■针对高危PCa的RP前NHT研究发现，NHT与不良病理特征减少有关，如pT3，阳性手术切缘（PSM），淋巴结受累.然而,尽管手术时间较短，手术结果有所改善，NHT并未显著增强生化复发（BCR）或其他肿瘤结局。使用ADT和雄激素受体信号传导抑制剂（ARSI）的联合疗法显示出不同的结果。另一项调查用紫杉烷类药物探索了NCHT，表明在高危PCa患者中可接受的治疗益处和改善的无BCR生存率，证明了这种方法的潜在可行性。正在进行的审判，就像PROTEUS的试验一样,目的进一步评价新辅助治疗对高危PCa的疗效。
■NHT治疗高危PCa无助于改善肿瘤预后，不应轻易用于降期或减少PSM。与单纯RP相比，NHT联合ARSI具有改善高危PCa肿瘤结局的潜在优势，但是目前的结果并不令人满意，并且需要使用几种不同的治疗方法开发个性化治疗策略。
■我们使用医学主题标题（MeSH）术语搜索了2005年1月1日至2023年3月30日在PubMed和Scopus数据库中发表的文章：前列腺癌，前列腺切除术,放射治疗,新辅助治疗,和治疗结果。
■针对高危PCa的RP前NHT研究发现，NHT与不良病理特征减少有关，如pT3，阳性手术切缘（PSM），淋巴结受累.然而,尽管手术时间较短，手术结果有所改善，NHT并未显著增强生化复发（BCR）或其他肿瘤结局。使用ADT和雄激素受体信号传导抑制剂（ARSI）的联合疗法显示出不同的结果。另一项调查用紫杉烷类药物探索了NCHT，表明在高危PCa患者中可接受的治疗益处和改善的无BCR生存率，证明了这种方法的潜在可行性。正在进行的审判，就像PROTEUS的试验一样,目的进一步评价新辅助治疗对高危PCa的疗效。
■NHT治疗高危PCa无助于改善肿瘤预后，不应轻易用于降期或减少PSM。与单纯RP相比，NHT联合ARSI具有改善高危PCa肿瘤结局的潜在优势，但是目前的结果并不令人满意，并且需要使用几种不同的治疗方法开发个性化治疗策略。
