Short-term clinicopathological outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade, followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with high-risk localized prostate cancer

World J Surg Oncol. 2012 Jan 4;10:1. doi: 10.1186/1477-7819-10-1.

Abstract

Background: To assess the outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with a high risk of localized prostate cancer (PCa).

Methods: Complete androgen blockade followed by 6 cycles of docetaxel (30 mg/m2) with estramustine phosphate (560 mg) were given to 18 PCa patients before radical prostatectomy. Subsequently, the clinical and pathological outcomes were analyzed.

Results: No patients had severe adverse events during chemohormonal therapy, and hence they were treated with radical prostatectomy. Two patients (11.1%) achieved pathological complete response. Surgical margins were negative in all patients. At a median follow-up of 18 months, 14 patients (77.8%) were disease-free without PSA recurrence. All 4 patients with PSA recurrence had pathologic T3b or T4 disease and 3 of these 4 patients had pathologic N1 disease.

Conclusion: We found that neoadjuvant chemohormonal therapy with complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy was safe, feasible, and associated with favorable pathological outcomes in patients with a high risk of localized PCa.

MeSH terms

  • Aged
  • Androgens / metabolism*
  • Anilides / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Docetaxel
  • Estramustine / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Leuprolide / administration & dosage
  • Male
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Neoplasm Staging
  • Nitriles / administration & dosage
  • Prostate-Specific Antigen
  • Prostatectomy*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / therapy*
  • Survival Rate
  • Taxoids / administration & dosage
  • Tosyl Compounds / administration & dosage
  • Treatment Outcome

Substances

  • Androgens
  • Anilides
  • Nitriles
  • Taxoids
  • Tosyl Compounds
  • Docetaxel
  • Estramustine
  • bicalutamide
  • Prostate-Specific Antigen
  • Leuprolide