ArticleBMC urology2026
Neoadjuvant hormone therapy plus robot-assisted radical prostatectomy improves pathologic outcomes in high-risk prostate cancer: a retrospective cohort study.
Article in BMC urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo assess the impact of neoadjuvant hormone therapy (NHT) prior to robot-assisted radical prostatectomy (RP) in high-risk prostate cancer (HRPCa).
methodsWe retrospectively analyzed 141 HRPCa patients who underwent robot-assisted RP from February 2022 to June 2025. According to whether NHT was administered preoperatively, patients were divided into NHT + RP group (n = 27) and RP-alone group (n = 114). The perioperative parameters and pathological outcomes were compared between groups.
resultsAt the baseline, the NHT + RP group had significantly higher fibrinogen (p = 0.003), AST (p = 0.034), PSA (p = 0.001), and PSA density (p < 0.001), indicating more aggressive disease. Even so, NHT + RP was associated with a trend toward reduced prostate volume (37.70 ± 31.14 vs. 46.07 ± 29.50 ml, p = 0.315) and improved pathological outcomes, including higher rates of pCR (18.5% vs. 0%, p < 0.001) and MRD (7.4% vs. 0%, p = 0.003), as well as a lower PSM rate (33.3% vs. 57.0%, p = 0.027). In multivariable analysis, NHT remained independently associated with reduced PSM (OR = 0.236, 95% CI: 0.068–0.820, p = 0.023).
conclusionPreoperative NHT followed by robot-assisted RP in HRPCa improved key pathological outcomes, including higher pCR/MRD and lower PSM rates. Given the inherent limitations of the retrospective design, prospective studies are required to validate these findings and their long-term clinical benefit.
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