#0950

Recovery of Urinary Continence After Neoadjuvant Hormonal Therapy Plus Radical Prostatectomy: A Multicenter Retro-prospective Cohort Study with Propensity Score Matching

Z. Zhang¹, J. Zhuang¹, H. Guo¹, S. Zhang¹

¹Nanjing, China

Introduction:

To evaluate the impact of neoadjuvant hormonal therapy (NHT) combined with robotic-assisted laparoscopic radical prostatectomy (RARP) on postoperative urinary continence recovery compared to RARP alone in patients with localized prostate cancer.

Material and methods:

A multicenter retro-prospective cohort study was conducted involving 2,453 patients treated between November 2018 and November 2023 at four tertiary hospitals in China. After applying exclusion criteria, 1,927 patients who completed one-year follow-up were included (760 NHT+RARP, 1,167 RARP alone). Propensity score matching (1:1) was performed based on age, prostate volume, body mass index, preoperative PSA level, surgical approach, and pathological T stage, resulting in 249 matched pairs. Urinary continence was defined as using no pad or one safety pad per day and assessed via standardized questionnaires during follow-up visits.

Results:

The NHT group demonstrated significantly better urinary continence recovery compared to the control group (P<0.001). Median recovery times were 8 weeks (95% CI: 13.61-17.70) for the NHT group and 16 weeks (95% CI: 18.34-23.01) for the control group. Early continence rates (2-12 weeks) were significantly higher in the NHT group (42.2% vs. 24.5%, P<0.001). Multivariate Cox regression analysis identified NHT (HR=1.273, 95% CI: 1.063-1.525, P=0.009) and age (HR=0.968, 95% CI: 0.955-0.980, P<0.001) as independent predictors of urinary continence recovery.