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

Öz

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.

Anahtar Kelimeler

• neoadjuvant
• docetaxel
• high-risk prostate cancer

Kaynakça

1. 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.
2. 2. D’Amico A V., Whittington R, Bruce Malkowicz S, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280(11):969–74.
3. 3. Mottet N, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, et al. EAU-EANM-ESTROESUR-SIOG Guidelines on Prostate Cancer—2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2021;79(2):243–62.
4. 4. De Bono JS, Oudard S, Ozguroglu M, Hansen S, MacHiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. The Lancet. 2010;376(9747):1147–54.
5. 5. Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer. N Engl J Med. 2004;351(15):1502–12.
6. 6. Dreicer R, Magi-Galluzzi C, Zhou M, Rothaermel J, Reuther A, Ulchaker J, et al. Phase II trial of neoadjuvant docetaxel before radical prostatectomy for locally advanced prostate cancer. Urology. 2004;63(6):1138–42.
7. 7. Febbo PG, Richie JP, George DJ, Loda M, Manola J, Shankar S, et al. Neoadjuvant Docetaxel before Radical Prostatectomy in Patients with High-Risk Localized Prostate Cancer. Clinical Cancer Research [Internet]. 2005 Jul 15 [cited 2023 Oct 18];11(14):5233–40. Available from: https://dx.doi. org/10.1158/1078-0432.CCR-05-0299
8. 8. Cha EK, Eastham JA. Chemotherapy and novel therapeutics before radical prostatectomy for high-risk clinically localized prostate cancer. Urologic Oncology: Seminars and Original Investigations. 2015;33(5):217–25.

9. 9. Basch E, Reeve BB, Mitchell SA, Clauser SB, Minasian LM, Dueck AC, et al. Development of the National Cancer Institute’s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PROCTCAE). JNCI. Journal of the National Cancer Institute. 2014;106(9):244.
10. 10. Sanda MG, Cadeddu JA, Kirkby E, Chen RC, Crispino T, Fontanarosa J, et al. Clinically Localized Prostate Cancer: AUA/ ASTRO/SUO Guideline. Part I. Risk Stratification, Shared Decision Making, and Care Options. J Urol. 2018;199(3):68390.
11. 11. Zhao B, Yerram NK, Gao T, Dreicer R, Klein EA. Long-term survival of patients with locally advanced prostate cancer managed with neoadjuvant docetaxel and radical prostatectomy. Urologic Oncology: Seminars and Original Investigations. 2015;33(4):164. e19–164. e23.
12. 12. Nosov A, Reva S, Petrov S, Mamijev E, Novikov R, Veliev E, et al. Neoadjuvant Chemotherapy Using Reduced-Dose Docetaxel Followed by Radical Prostatectomy for Patients With Intermediate and High-Risk Prostate Cancer: A Single-Center Study. Prostate. 2016;76(15):1345–52.
13. 13. Klein EA, Dreicer R. Initial Experience with Single-Agent Docetaxel as Neoadjuvant Therapy in Men with Locally Advanced Prostate Cancer. Rev Urol 2006/09/21. 2003;5(Suppl 3):S22.
14. 14. Thuret R, Massard C, Gross-Goupil M, Escudier B, Di Palma M, Bossi A, et al. The postchemotherapy PSA surge syndrome. Annals of Oncology. 2008;19(7):1308–11.
15. 15. Harisinghani MG, Barentsz J, Hahn PF, Deserno WM, Tabatabaei S, van de Kaa CH, et al. Noninvasive Detection of Clinically Occult Lymph-Node Metastases in Prostate Cancer. N Engl J Med. 2003;348(25):2491–9.
16. 16. Hövels AM, Heesakkers RAM, Adang EM, Jager GJ, Strum S, Hoogeveen YL, et al. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol. 2008;63(4):387–95.
17. 17. Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2017;71(4):618–29.
18. 18. Mohler J, Bahnson RR, Boston B, Busby JE, D’Amico A, Eastham JA, et al. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw. 2010;8(2):162–200.
19. 19. Graham J, Baker M, Macbeth F, Titshall V. Diagnosis and treatment of prostate cancer: summary of NICE guidance. BMJ. 2008;336(7644):610–2.
20. 20. Horwich A, Parker C, Bangma C, Kataja V. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2010;21(SUPPL. 5):v129–33.
21. 21. Cooperberg MR, Lubeck DP, Mehta SS, Carroll PR, Kantoff PW, Smith MR, et al. Time Trends in Clinical Risk Stratification for Prostate Cancer: Implications for Outcomes (Data From CaPSURE). J Urol. 2003;170(6 II).