Endocrine Treatment prior to Radical Retropubic Prostatectomy in Patients with T3 Prostate Cancer: A Retrospective Study of 22 Patients

Abstract

Twenty-two patients with locally advanced prostatic carcinoma stage T₃, N₀, M₀ have been treated with LH-RH agonists during a mean time of 5 months prior to radical retropubic prostatectomy. Although tumors appeared to be confined to the organ in 68% of the patients after endocrine treatment, pathological examination of the surgical specimens showed in 89% evidence of extraprostatic disease, which questions the clinical impression of ‘downstaging’. A disparity between the tumor grade of the biopsy and that of the operative specimen as well as an increased size of tumor-involved lymph nodes despite endocrine treatment led us to speculate that a certain proportion of patients will bear the risk of disease progression during preoperative androgen deprivation. Furthermore, there was local recurrence early in the postoperative course and at the high rate of 39%.