Objectives.To compare the pathologic stage and surgical margin status in patients undergoing eitherimmediate radical prostatectomy or surgery preceded by 3 or 6 months of neoadjuvant hormonal treatment(NHT) in a prospective, randomized study.Methods.Four hundred thirty-one men with prostate cancer were enrolled in the Italian randomizedprospective PROSIT study. The whole-mount sectioning technique was used. By May 1999, the reviewingpathologist had evaluated 303 specimens. One hundred seven patients were untreated before radicalprostatectomy was performed, and 114 and 82 patients had been treated for 3 and 6 months, respectively,with complete androgen blockade.Results.Pathologic organ-confined disease was found in 63.1% of patients with clinical Stage B diseasetreated with 6 months of NHT versus 61.0% after 3 months of NHT and 37.5% after immediate surgery.Among patients with clinical Stage C tumors, pathologic staging found organ-confined disease in 62.5%,32.1%, and 11.1% of patients after 6 months of NHT, 3 months of NHT, and immediate surgery, respectively.Three months of NHT produced a significant increase in negative margins both in patients with clinical StageB and C disease, but the addition of another 3 months of treatment did not significantly improve this result.A lower degree of benefit was observed in patients with clinical Stage C tumors.Conclusions.This study shows that complete androgen blockade before surgery is beneficial in men withclinical Stage B disease. The effects are more pronounced after 6 months of NHT than after 3months.UROLOGY57:117–121, 2001. © 2001, Elsevier Science Inc
Effect of complete androgen blockade on pathologic stage and resection margin status of prostate cancer: progress pathology report of the Italian PROSIT study
SELLI, CESARE
2001-01-01
Abstract
Objectives.To compare the pathologic stage and surgical margin status in patients undergoing eitherimmediate radical prostatectomy or surgery preceded by 3 or 6 months of neoadjuvant hormonal treatment(NHT) in a prospective, randomized study.Methods.Four hundred thirty-one men with prostate cancer were enrolled in the Italian randomizedprospective PROSIT study. The whole-mount sectioning technique was used. By May 1999, the reviewingpathologist had evaluated 303 specimens. One hundred seven patients were untreated before radicalprostatectomy was performed, and 114 and 82 patients had been treated for 3 and 6 months, respectively,with complete androgen blockade.Results.Pathologic organ-confined disease was found in 63.1% of patients with clinical Stage B diseasetreated with 6 months of NHT versus 61.0% after 3 months of NHT and 37.5% after immediate surgery.Among patients with clinical Stage C tumors, pathologic staging found organ-confined disease in 62.5%,32.1%, and 11.1% of patients after 6 months of NHT, 3 months of NHT, and immediate surgery, respectively.Three months of NHT produced a significant increase in negative margins both in patients with clinical StageB and C disease, but the addition of another 3 months of treatment did not significantly improve this result.A lower degree of benefit was observed in patients with clinical Stage C tumors.Conclusions.This study shows that complete androgen blockade before surgery is beneficial in men withclinical Stage B disease. The effects are more pronounced after 6 months of NHT than after 3months.UROLOGY57:117–121, 2001. © 2001, Elsevier Science IncI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
