Neoadjuvant Hormonal Therapy Before Radical Prostatectomy Decreases the Number of Positive Surgical Margins in Stage T2 Prostate Cancer

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Abstract
We investigated the effect of neoadjuvant treatment before radical prostatectomy for clinically localized prostate cancer. A total of 130 patients with stages T2b and T3 prostate cancer was randomized in a multicenter study: 62 underwent immediate radical prostatectomy and 65 received 560 mg. estramustine phosphate daily for 6 weeks preoperatively. For clinical stage T2b tumors the neoadjuvant treatment resulted in a significant decrease in positive surgical margins compared to the nonpretreated group. This difference was not found for clinical stage T3 tumors. The impact on progression and survival still must be analyzed. Neoadjuvant treatment can be beneficial for clinical stage T2 prostate cancer. Optimal treatment for stage T3 tumors remains controversial.