HORMONE ABLATION THERAPY AS NEOADJUVANT TREATMENT TO RADICAL PROSTATECTOMY

Two hundred consecutive patients with presumed localized prostate canc er had radical prostatectomy alone (n = 119) or were treated for an av erage period of 3 months with combination therapy using the antiandrog en flutamide and one luteinizing hormone-releasing hormone (LHRH) agon ist (Lupron or Zoladex). The positive margins decreased from 35.3% in the group undergoing prostatectomy alone to 11.5% in the group of men who received combination therapy before radical prostatectomy. In 41 a pical tumors, the incidence of positive margins decreased from 50% in the control group to 18.6% in the combination therapy group. In stage C disease, the incidence of positive tumor showed a tendency to decrea se with the extended duration of endocrine treatment with a rate of 37 .5% after 3 months and 16.7% after 6 months. Whether the decreased inc idence of positive surgical margins will all translate into prolonged survival remains to be verified by long-term follow-up of these patien ts. However, the initial results obtained in the present study are ver y encouraging.