Materials and Methods: Patients received NHT prior to RaLRP by a single surgeon were identified from the VGHTC Prostate Cancer Database. Control group was picked out via computerized 1:1 ratio matching with the following criteria: (1) prostate specific antigen (PSA) level at diagnosis (2) initial Gleason score (3) clinical stage (4) Age. NHT regimens include combination of Luteinising hormone-releasing hormone (LHRH) agonist with anti-androgens and individual use of either LHRH agonist or anti-androgens. General characters of patients, peri-operative parameters, functional and oncologic outcome were prospectively recorded.

Results: Total 48 patients with D’Amico intermediate- and high-risk CaP were analyzed. The mean patient age, BMI, preoperative PSA, and Gleason score at biopsy appears equivalent but there’re significant statistic higher percentage of cT2c in control group and a trend of higher percentage of cT3b in NHT group. Shorter operative time (153.5 minutes v.s. 113.3 minutes, p=0.0002) and lesser amount of blood loss (147.08ml v.s. 93.75ml, p=0.131) were found in NHT group. The average period of biochemical recurrence (BCR) was similar (5.33 months v.s. 6.54 months, p=0.523) but the overall BCR rate was significantly lower in NHT group (87.5% v.s. 54.2%, p=0.026). In sub-group analysis, BCR rate was significant lower in NHT group if preoperative PSA level were between 10 to 20 ng/ml (66.67% v.s. 0%, p=0.035) and >50 ng/ml (100% v.s. 55.56%, p=0.018) while BCR rate was 81.82% v.s. 80% (p=0.916) in PSA 20-50 ng/ml. However, average follow-up period was significantly insufficient in NHT group (49.46 months v.s. 20.29 months, p<0.001) although BCR usually happened in the  postoperative first year in our study.

Conclusions: Neoadjuvant NHT followed by RaLRP seems to provide some potential benefits in shorter operative time, lesser amount of blood loss, and lower rate of BCR during postoperative two years in patients with intermediate- or high-risk localized CaP.