Neoadjuvant hormonal therapy and radical prostatectomy in the treatment of clinical stage T3 XXXX .

@entity1 @entity263 @entity5
We evaluated the results of a treatment protocol that consisted of neoadjuvant hormonal therapy followed by radical retropubic prostatectomy (RRP) for clinical stage T3 (cT3) @entity263 . Sixty-six @entity1 with cT3 @entity263 underwent staging procedures that included metastatic work-up and evaluation under anesthesia. Neoadjuvant hormonal treatment was given for 3 to 6 months, followed by re-evaluation under anesthesia. @entity1 considered to have a resectable prostate following neoadjuvant treatment underwent operation. Disease-free survival [prostate-specific antigen (PSA) < 0.1 ng/ml] was calculated by the Kaplan-Meier method for cT3 @entity1 and for a group of @entity1 with clinical stage 1 and 2 disease (cT1-2), who underwent RRP without neoadjuvant hormonal therapy. @entity1 with pT3 disease in both groups received early adjuvant radiation treatment. @entity1 in the cT3 group who were not clinically downstaged were treated with radiation. @entity1 with positive lymph nodes continued hormonal therapy. The pretreatment PSA for the cT3 group was 43.6    55.6 ng/ml, and 10.64    7.18 ng/ml for the cT1-2 group (p < 0.05). Of 66 cT3 @entity1 , 53 (80%) were clinically downstaged and operated on and 47 (71%) underwent RRP. At 36 months, there was no significant difference in the PSA relapse rate between these two groups; both had significantly lower rates than did @entity1 in the cT3 without RRP. At 48 months, 79% (21 @entity1 ) of the @entity1 in the cT3-RRP group were disease free compared with 50% of those in the cT3 without RRP (4 @entity1 ). Neoadjuvant hormonal therapy for stage cT3 @entity263 selects @entity1 whose @entity5 can be controlled by RRP for an extended period of time.
