gms | German Medical Science

Introduction: Neoadjuvant hormonal therapy (NHT) prior to robot assisted radical prostatectomy (RARP) may be beneficial in high risk cases to facilitate the surgical resection and improve local tumor control. Thus, HT is associated with major side effect. Its benefit regarding the overall cancer survival is not evident and it may worsen sexual and hormonal functions. This study aim to investigate the effect of NHT on the perioperative course after RARP.

Methods: 500 patients from a tertiary referral centers who underwent RARP were retrospectively included. Patients were divided into two groups NHT (n=55, 11%) patients received NHT (median 1 month prior to RARP) and group no neoadjuvant hormonal therapy NNHT (n=445, 89%). Demographic and perioperative data were analyzed. Postoperative results, complications and readmission rates were compared between groups.

Results: NHT patients were heterogenous from our cohort regarding cancer parameters like PSA, risk groups distribution and they were more comorbid. They also received less nerve sparing procedures while OR time were similar. PSM and PLN were significantly higher in NHT group. whereas hospital stay was equal, catheter days were 3 days longer in NHT group. They also suffered more minor VUA related complication. Major complications and readmissions didn’t differ between groups.

Conclusion: NHT does not put patients at elevated risk for higher complications or readmissions after RARP. Patients with unfavorable high risk tumors may benefit from NHT since it improves local tumor control and facilitate the surgical resection. Further randomized controlled trials are indispensable.