The Impact of Neoadjuvant Hormonal Therapy on the Outcome of Laparoscopic Radical Prostatectomy: A Matched Pair Analysis

PurposeWe evaluated the effect of androgen ablation treatment on laparoscopic radical prostatectomy operative and postoperative parameters.Materials and MethodsA total of 50 patients (group 1) on neoadjuvant androgen deprivation, followed by laparoscopic radical prostatectomy, were compared to 50 (group 2) without any treatment who were matched for prostate volume, laparoscopic pelvic lymphadenectomy, nerve sparing procedure, surgical access type and pathological stage. We analyzed operative time, blood loss, intraoperative and postoperative complications, catheter time, procedure difficulty as scored by the surgeon and surgical margin status.ResultsThere was no significant difference between the neoadjuvant and nonneoadjuvant groups with respect to mean operative time ± SD (228.6 ± 62.9 vs 219.4 ± 65.1 minutes), mean blood loss (667.6.1 ± 217.1 vs 729.8 ± 285.1 ml) and median catheter time (7 vs 7.5 days). We also found no difference related to the complication rate. Ten of 50 prostate dissections (20%) in group 1 were classified as difficult, whereas in group 2 only 4 of 50 (8%) were scored as difficult (p = 0.084). The positive surgical margin rates did not differ.ConclusionsThere was no significant difference with respect to operative or postoperative parameters in patients undergoing neoadjuvant androgen ablation therapy compared to controls. At centers where there is experience laparoscopic radical prostatectomy can be safely performed in patients who have undergone neoadjuvant hormonal therapy.