The Application And Effect Analysis Of Neoadjuvant Hormonal Therapy In Treatment Of Localized High Risk Prostate Cancer

Objective:To assess the clinical effect of neoadjuvant hormonal therapy(NHT)in localized high-risk prostate cancer and to compare with the cases treated by radical prostatectomy without NHT.Methods:A total of 74 localized high risk prostate caner patients diagnosed by prostate puncture and biopsy in our hospital during March 2014 and March 2017 were enrolled,of which 64 cases treated with laparoscopic prostatectomy merely were classified in group A,10 cases treated with a consecutive cure of NHT and laparoscopic prostatectomy were classified in group B.According to the electronic medical record,outpatient check-ups and phone call following-up,collecting the relative data of operation and postoperative recovery state.Evaluate the differences of two groups at operation time,blood loss during operation,volume of prostate,postoperative hospitalization duration,rectal injury,positive surgical margins and rates of lymphatic metastasis,seminal vesicle invasion,capsule invasion,uracratia,biochemical recurrence,metastasis.Asses the clinical effect of NHT in localized high-risk prostate cancerResults:74 localized high-risk prostate cancer cases were enrolled.The average age is68.68±6.07y.There were 64 cases in group A and 10 cases in group B.The follow-up time was 3~36 months.The median follow-up time was 16 months,of which the median follow-up time was 17 months in group A,and the median follow-up time in group B was10 months.In group B,the prostate volume declined from 44.11±16.45ml to 23.63±7.47ml and the PSA level declined from 79.53±28.84ng/ml to 0.23±0.31ng/ml after NHT,and the difference was statistically significant(P<0.05).The clinical stage of 4 cases degraded:respectively are 2 cases,T3_b dropped to T3_a and 2 cases,T3_a dropped to T2_c?The Gleason score of 3 cases declined and 1 case rised,respectively are 5+5 dropped to 5+4,5+4dropped to 4+5,4+5 dropped to 4+4 and 3+4 rised to 4+5.The operation time,blood loss,rectal injury rate,surgical positive margins,seminal vesicle invasion rate,lymph node metastasis rate,incidence of urinary incontinence and biochemical recurrence rate and metastasis rate in group B were lower than those in group A,but the difference was not significant(P>0.05).Conclusions:NHT is a efficient treatment for localized high-risk prostate cancer.For cases with high PSA level,adhesions to the rectum or pelvic wall,and large prostate volume,the tumor can be degraded by NHT,allowing the patients to undergo radical surgery...