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. 2023 Apr 23;13(5):1072.
doi: 10.3390/life13051072.

Efficacy and Safety of Neoadjuvant Luteinizing Hormone-Releasing Hormone Antagonist and Tegafur-Uracil Chemohormonal Therapy for High-Risk Prostate Cancer

Fumiya Sugino  1 , Keita Nakane  1 , Makoto Kawase  1 , Shota Ueda  2 , Masayuki Tomioka  3 , Yasumichi Takeuchi  4 , Risa Tomioka-Inagawa  1 , Toyohiro Yamada  1 , Sanae Namiki  1 , Naotaka Kumada  1 , Shinichi Takeuchi  1 , Kota Kawase  1 , Daiki Kato  1 , Manabu Takai  1 , Koji Iinuma  1 , Yuki Tobisawa  5 , Takuya Koie  1
Affiliations

Efficacy and Safety of Neoadjuvant Luteinizing Hormone-Releasing Hormone Antagonist and Tegafur-Uracil Chemohormonal Therapy for High-Risk Prostate Cancer

Fumiya Sugino et al. Life (Basel). .

Abstract

Background: This retrospective single-center cohort study evaluated the efficacy and safety of a combination of neoadjuvant luteinizing hormone-releasing hormone (LHRH) antagonist and tegafur-uracil (UFT) therapy (NCHT) and investigated the medical records of patients with high-risk PCa who underwent robot-assisted radical prostatectomy (RARP). The therapy was followed by RARP for high-risk PCa.

Materials and methods: The enrolled patients were divided into two groups: low-intermediate-risk PCa patients who underwent RARP without neoadjuvant therapy (non-high-risk) and those who underwent NCHT followed by RARP (high-risk group). This study enrolled 227 patients (126: non-high-risk and 101: high-risk group). Patients in the high-risk-group had high-grade cancer compared to those in the non-high-risk-group.

Results: At the median follow-up period of 12.0 months, there were no PCa deaths; two patients (0.9%) died of other causes. Twenty patients developed biochemical recurrence (BCR); the median time until BCR was 9.9 months after surgery. The 2-year biochemical recurrence-free survival rates were 94.2% and 91.1% in the non-high-risk and high-risk-group, respectively (p = 0.465). Grade ≥3 NCHT-related adverse events developed in nine patients (8.9%).

Conclusions: This study indicates that combining neoadjuvant LHRH antagonists and UFT followed by RARP may improve oncological outcomes in patients with high-risk PCa.

Keywords: high-risk prostate cancer; luteinizing hormone-releasing hormone antagonist; neoadjuvant chemohormonal therapy; robot-assisted radical prostatectomy; tegafur-uracil.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Analysis of biochemical recurrence-free survival (BRFS) using the Kaplan–Meier method in all patients receiving RARP of this study. The 1- and 2-year BRFS rates in all patients were 95.8% and 92.0%, respectively.
Figure 2
Figure 2
Kaplan–Meier estimate of the biochemical recurrence after robot-assisted radical cystectomy in patients with or without receiving neoadjuvant chemohormonal therapy. The 2-year biochemical recurrence-free survival rates were 93.9% and 89.5% in the non-high-risk group (A) and high-risk group (B), respectively (p = 0.542).
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