| Background and ObjectiveWith the development of China's social economy,the health industry continues to progress,and the population is aging,the incidence of prostate cancer in China has increased year by year.Many patients come to see a doctor after the symptoms appear.At this time,a considerable part of the patient has entered the advanced stage.The recovery of this stage is obviously worse than the early stage,often recurring early after surgery,and even losing the chance of surgery.Hormone therapy is an important treatment for prostate cancer.It can be used to degrade and lower the tumor before surgery.High-risk patients therefore have access to surgery.This study retrospectively analyzed the efficacy of neoadjuvant hormone therapy combined with radical prostatectomy and surgery alone in high-risk patients.The clinical significance of neoadjuvant therapy and the choice of high-risk prostate cancer treatment options were revisited.MethodsIn this study,129 cases of high-risk prostate cancer were diagnosed and diagnosed by the Department of Urology,Zhujiang Hospital,Southern Medical University from January 2006 to March 2018,including 65 cases of neoadjuvant(NHT)group.Surgery(RP)group of 64 patients.Clinical data and follow-up data were collected.The comparison between the NHT group and the RP group was performed,and the data of the study group were analyzed in the first,third,and sixth months.Methods SPSS22.0 was used for data analysis.The t-test or one-way analysis of variance was performed on the normal distribution data.The Fisher's test was used to compare the survival rate.The survival characteristics were analyzed by Kaplan-Meier method.The log-rank test survival difference was p<0.05.The difference is statistically significant.ResultsA total of 129 patients with high-rnsk prostate cancer were enrolled.All patients underwent laparoscopic radical prostatectomy and lymphadenectomy.No serious complications occurred during the perioperative period.The follow-up period was 3 to 96 months.The median follow-up time was included.It is 37.5 months.There was no significant difference in age,height,BMI index,first-time PSA value,puncture Gleason score,and preoperative TNM stage between the NHT group and the RP group.The PSA and prostate volume were significantly lower in the NHT group than before surgery,while the Gleason score was increased.The difference was statistically significant.NHT margin positive rate,lymph node positive rate,and seminal vesicle infiltration rate were lower than RP group,but the difference was not statistically significant.The biochemical recurrence rate was 3 years(35.8 vs 42.2%,p=0.591),and there was no statistical difference in survival analysis between the two groups(p=0.314).According to the preoperative adjuvant treatment time,it was divided into three groups:A,B,and C in January,March,and June,and the number of cases included in each group was 17,23,and 10.As endocrine therapy time increases,PSA and prostate volume are further reduced.There was no significant difference in lymph node positive rate,positive margin and seminal vesicle infiltration rate.The recurrence rate of the B group was higher than that of the other two groups(p=0.011),and the survival analysis indicated that there was no difference between the three groups(p=0.733).Conclusion1.Neoadjuvant hormone therapy does not increase the difficulty of surgery and the incidence of complications,which can reduce the PSA value and tumor down-stage,including positive margin,positive lymph node rate,and seminal vesicle infiltration rate,which are lower than surgery alone,but there is no Statistical significance,and no statistical significance in biochemical recurrence rate and survival analysis,failed to make patients benefit from survival.2.The increase of preoperative hormone therapy time can further reduce the PSA value and prostate volume,but it also does not increase the survival benefit of patients. |
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