Determination of the Effects of Docetaxel Chemotherapy on Surgical Results and Survival in High-Risk Locally Advanced Prostate Cancer Before Radical Prostatectomy

Abstract

Aim: Determination of the effect of neo-adjuvant docetaxel chemotherapy combined with radical prostatectomy (RP) on surgical outcome and survival. Material and Method: The data of 132 non-metastatic prostate cancer (PC) patients, considered high-risk according to the D’Amico Risk Stratification System and who underwent radical prostatectomy, among those who applied to the Hacettepe University Faculty of Medicine Urology Clinic between August 1987 and August 2017, were retrospectively evaluated. Data from 28 patients selected via pair matching from the group operated without chemotherapy and 14 patients identified to have received neoadjuvant androgen deprivation therapy (NADT) preoperatively were compared regarding biochemical recurrence, survival, surgical outcomes, and some additional variables. Results: The findings of our study revealed that, while NADC is usually tolerated well by patients and can be administered without severe side effects, it has no statistically significant advantage on PSA values (p=0.145), Gleason scores, and pathologic stages (p=0.273, p=0.109), biochemical recurrence risk (p=0.040) and overall survival (p=0.527). It did not affect surgical complication rates, may have benefitted malignant involvement of lymph nodes, and prolonged biochemical relapse-free survival time. Conclusion: In high-risk PC patients, the ineffectiveness of neoadjuvant androgen deprivation therapy in combination with RP suggests the presence of castration-resistant cell clones that exist at the time of the diagnosis and brings up treatment options that could be effective on castration-resistant clones as systemic treatments. As a neo-adjuvant treatment, combining docetaxel chemotherapy with RP can be beneficial.

Keywords

• neoadjuvant
• docetaxel
• high-risk prostate cancer

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