A cohort analysis of patients receiving neoadjuvant androgen deprivation therapy (neoADT) prior to robot-assisted laparoscopic prostatectomy (RALP) during the Covid-19 pandemic

Abstract

Objectives: To investigate localised prostate cancer (PCa) treated with or without neoadjuvant androgen deprivation therapy (neoADT) prior to robot-assisted laparoscopic prostatectomy (RALP), and the impact of coronavirus-19 disease (Covid-19) treatment disruption, on clinico-pathologic outcomes. Patients and methods: Data was retrospectively collected from 124 consecutive patients treated with RALP between November 2019 to September 2020. 62 patients were treated before March 13th (historic cohort) and 62 afterwards (covid cohort). 37 patients in covid cohort additionally received neoADT (mean duration of 3 months) consisting of Bicalutamide 150mg OD for 4 weeks, with Leuprolide 3.75mg monthly injections commencing after week 1, up until the surgical date. Results: Statistical analysis found no difference to peri-operative measures and length of stay for patients treated with or without neoADT. Patients with delayed surgical treatment offered neoADT showed a trend towards a reduction in positive surgical margins (P = 0.134), N1 disease (P = 0.424) and pathological down-staging (50% patients with pT2 disease). Patients within covid cohort experienced significantly increased detectable PSA levels (P < 0.007). Conclusion: Our study demonstrated that a 3-month duration of neoADT prior to RALP may improve pathological outcomes but this timeframe is inadequate to influence detectable PSA levels. Covid-19-related treatment delays led to significantly increased detectable PSA levels.

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http://creativecommons.org/licenses/by-nc-nd/4.0/

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DOI

http://dx.doi.org/10.1177/20514158211022216

Repository URI

http://eprints.gla.ac.uk/242055/