8-MONTH NEOADJUVANT HORMONAL THERAPY BEFORE RADICAL PROSTATECTOMY FOR HIGH-RISK PROSTATE CANCER
(Purpose) To evaluate the clinicopathological outcomes of 8 months of neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy for high-risk prostate cancer. (Patients and Methods) A multi-institutional prospective trial was performed between July 2000 and May 2003 involving high-risk prost...
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| Veröffentlicht in: | Nippon Hinyokika Gakkai zasshi 2006/07/20, Vol.97(5), pp.712-718 |
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| creator | Tabata, Ken-ichi Satoh, Takefumi Matsumoto, Kazumasa Fujita, Tetsuo Irie, Akira Iwamura, Masatsugu Yanagisawa, Nobuyuki Matsuda, Daisuke Muramoto, Masatoshi Kadowaki, Kazuomi Suyama, Kazuho Shoji, Kiyoshi Koh, Hideshige Kawakami, Tatsuo Okayasu, Isao Egawa, Shin Baba, Shiro |
| description | (Purpose) To evaluate the clinicopathological outcomes of 8 months of neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy for high-risk prostate cancer. (Patients and Methods) A multi-institutional prospective trial was performed between July 2000 and May 2003 involving high-risk prostate cancer patients without metastasis, including 21 who received 8 months of NHT before radical prostatectomy. High-risk group was defined as clinical stage ≥T2c and/or prostate-specific antigen (PSA) >20ng/ml and/or Gleason score ≥8. PSA values were considered elevated (biochemical failure) if values of 0.1ng/ml or greater were obtained. (Results) Median of initial PSA levels before prostate biopsy was 27.6ng/ml (8.5-80.7ng/ml), and median of pre-operative PSA levels after NHT was 0.28ng/ml (0.02-4.2ng/ml). There were 5 patients (23.8%) with lower limit of PSA detection (less than 0.02ng/ml) in 8 months after NHT. The clinical T stage was T1c in 9 patients (42.9%), T2a-b in 8 patients (38.1%), T2c in 3 patients (14.3%), and T3a in 1 patient (4.8%). The median follow-up was 25 months (range 4 to 37). There were 2 patients (9.5%) in pT0, 5 patients (23.8%) with positive surgical margin, 5 patients (23.8%) with extracapsular extension (ECE) and 3 patients (14.3%) with seminal vesicle involvement (SVI). Biochemical failure was occurred in 9 of 21 (42.9%) including of one pT0. Range of time to postoperative biochemical failure was 2 to 25 months (median 6 months) and most of biochemical failure was found within 12 months after surgery. Biochemical failure rate was significantly higher in patient with positive SVI (p=0.0308) and higher in patients with pre-operative PSA levels of more than 0.1ng/ml (p=0.0836), positive ECE (p=0.0545) and positive surgical margin (p=0.0545). (Conclusion) Biochemical failure was frequent after this combined treatment, even in a pT0 case. Long-term follow-up of patients is needed to assess the impact of this therapy on mortality. |
| doi_str_mv | 10.5980/jpnjurol1989.97.712 |
| format | Article |
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(Patients and Methods) A multi-institutional prospective trial was performed between July 2000 and May 2003 involving high-risk prostate cancer patients without metastasis, including 21 who received 8 months of NHT before radical prostatectomy. High-risk group was defined as clinical stage ≥T2c and/or prostate-specific antigen (PSA) >20ng/ml and/or Gleason score ≥8. PSA values were considered elevated (biochemical failure) if values of 0.1ng/ml or greater were obtained. (Results) Median of initial PSA levels before prostate biopsy was 27.6ng/ml (8.5-80.7ng/ml), and median of pre-operative PSA levels after NHT was 0.28ng/ml (0.02-4.2ng/ml). There were 5 patients (23.8%) with lower limit of PSA detection (less than 0.02ng/ml) in 8 months after NHT. The clinical T stage was T1c in 9 patients (42.9%), T2a-b in 8 patients (38.1%), T2c in 3 patients (14.3%), and T3a in 1 patient (4.8%). The median follow-up was 25 months (range 4 to 37). There were 2 patients (9.5%) in pT0, 5 patients (23.8%) with positive surgical margin, 5 patients (23.8%) with extracapsular extension (ECE) and 3 patients (14.3%) with seminal vesicle involvement (SVI). Biochemical failure was occurred in 9 of 21 (42.9%) including of one pT0. Range of time to postoperative biochemical failure was 2 to 25 months (median 6 months) and most of biochemical failure was found within 12 months after surgery. Biochemical failure rate was significantly higher in patient with positive SVI (p=0.0308) and higher in patients with pre-operative PSA levels of more than 0.1ng/ml (p=0.0836), positive ECE (p=0.0545) and positive surgical margin (p=0.0545). (Conclusion) Biochemical failure was frequent after this combined treatment, even in a pT0 case. Long-term follow-up of patients is needed to assess the impact of this therapy on mortality.</description><identifier>ISSN: 0021-5287</identifier><identifier>EISSN: 1884-7110</identifier><identifier>DOI: 10.5980/jpnjurol1989.97.712</identifier><identifier>PMID: 16898594</identifier><language>eng ; jpn</language><publisher>Japan: THE JAPANESE UROLOGICAL ASSOCIATION</publisher><subject>Aged ; Androgen Antagonists - administration & dosage ; Anilides - administration & dosage ; Antineoplastic Agents, Hormonal - administration & dosage ; biochemical failure ; Biomarkers, Tumor - blood ; Chemotherapy, Adjuvant ; Goserelin - administration & dosage ; high-risk prostate cancer ; Humans ; Leuprolide - administration & dosage ; Male ; Middle Aged ; neoadjuvant hormonal therapy ; Neoadjuvant Therapy ; Neoplasm Staging ; Nitriles ; Prospective Studies ; Prostate-Specific Antigen - blood ; Prostatectomy ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - therapy ; Risk ; Time Factors ; Tosyl Compounds ; Treatment Failure</subject><ispartof>The Japanese Journal of Urology, 2006/07/20, Vol.97(5), pp.712-718</ispartof><rights>Japanese Urological Association</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16898594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tabata, Ken-ichi</creatorcontrib><creatorcontrib>Satoh, Takefumi</creatorcontrib><creatorcontrib>Matsumoto, Kazumasa</creatorcontrib><creatorcontrib>Fujita, Tetsuo</creatorcontrib><creatorcontrib>Irie, Akira</creatorcontrib><creatorcontrib>Iwamura, Masatsugu</creatorcontrib><creatorcontrib>Yanagisawa, Nobuyuki</creatorcontrib><creatorcontrib>Matsuda, Daisuke</creatorcontrib><creatorcontrib>Muramoto, Masatoshi</creatorcontrib><creatorcontrib>Kadowaki, Kazuomi</creatorcontrib><creatorcontrib>Suyama, Kazuho</creatorcontrib><creatorcontrib>Shoji, Kiyoshi</creatorcontrib><creatorcontrib>Koh, Hideshige</creatorcontrib><creatorcontrib>Kawakami, Tatsuo</creatorcontrib><creatorcontrib>Okayasu, Isao</creatorcontrib><creatorcontrib>Egawa, Shin</creatorcontrib><creatorcontrib>Baba, Shiro</creatorcontrib><title>8-MONTH NEOADJUVANT HORMONAL THERAPY BEFORE RADICAL PROSTATECTOMY FOR HIGH-RISK PROSTATE CANCER</title><title>Nippon Hinyokika Gakkai zasshi</title><addtitle>Jpn. j. urol</addtitle><description>(Purpose) To evaluate the clinicopathological outcomes of 8 months of neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy for high-risk prostate cancer. (Patients and Methods) A multi-institutional prospective trial was performed between July 2000 and May 2003 involving high-risk prostate cancer patients without metastasis, including 21 who received 8 months of NHT before radical prostatectomy. High-risk group was defined as clinical stage ≥T2c and/or prostate-specific antigen (PSA) >20ng/ml and/or Gleason score ≥8. PSA values were considered elevated (biochemical failure) if values of 0.1ng/ml or greater were obtained. (Results) Median of initial PSA levels before prostate biopsy was 27.6ng/ml (8.5-80.7ng/ml), and median of pre-operative PSA levels after NHT was 0.28ng/ml (0.02-4.2ng/ml). There were 5 patients (23.8%) with lower limit of PSA detection (less than 0.02ng/ml) in 8 months after NHT. The clinical T stage was T1c in 9 patients (42.9%), T2a-b in 8 patients (38.1%), T2c in 3 patients (14.3%), and T3a in 1 patient (4.8%). The median follow-up was 25 months (range 4 to 37). There were 2 patients (9.5%) in pT0, 5 patients (23.8%) with positive surgical margin, 5 patients (23.8%) with extracapsular extension (ECE) and 3 patients (14.3%) with seminal vesicle involvement (SVI). Biochemical failure was occurred in 9 of 21 (42.9%) including of one pT0. Range of time to postoperative biochemical failure was 2 to 25 months (median 6 months) and most of biochemical failure was found within 12 months after surgery. Biochemical failure rate was significantly higher in patient with positive SVI (p=0.0308) and higher in patients with pre-operative PSA levels of more than 0.1ng/ml (p=0.0836), positive ECE (p=0.0545) and positive surgical margin (p=0.0545). (Conclusion) Biochemical failure was frequent after this combined treatment, even in a pT0 case. Long-term follow-up of patients is needed to assess the impact of this therapy on mortality.</description><subject>Aged</subject><subject>Androgen Antagonists - administration & dosage</subject><subject>Anilides - administration & dosage</subject><subject>Antineoplastic Agents, Hormonal - administration & dosage</subject><subject>biochemical failure</subject><subject>Biomarkers, Tumor - blood</subject><subject>Chemotherapy, Adjuvant</subject><subject>Goserelin - administration & dosage</subject><subject>high-risk prostate cancer</subject><subject>Humans</subject><subject>Leuprolide - administration & dosage</subject><subject>Male</subject><subject>Middle Aged</subject><subject>neoadjuvant hormonal therapy</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm Staging</subject><subject>Nitriles</subject><subject>Prospective Studies</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - therapy</subject><subject>Risk</subject><subject>Time Factors</subject><subject>Tosyl Compounds</subject><subject>Treatment Failure</subject><issn>0021-5287</issn><issn>1884-7110</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkF1PwjAUhhujEYL8AhOzK--Gbdeu7eUcg6HCyBgmXDVb1ylkfLjChf_eEgiaeHNOcs5znpy8ANwj2KOCw6fVbrM6NNsaCS56gvUYwlegjTgnLkMIXoM2hBi5FHPWAl1jlgX0EOOYe94taCGfC04FaQPJ3XEyyWJnEiVB_2X-HkwyJ05SOwzenCyO0mC6cJ6jQZJGThr0R6EdT9NklgVZFGbJeOHYlROPhrGbjmavl50TBpMwSu_ATZXXRnfPvQPmgygLY_ctGR5drsL2K9cjlS9QgWCBaMkhKwn1BFIMEh_DUhHil5wqVFUKUk0qjBErc1oWJSOYCMK9Dng8eXfN9uugzV6ul0bpus43ensw0ucMM4qxBb0TqJqtMY2u5K5ZrvPmWyIoj9HKv9FKwaSN1l49nPWHYq3L35tzkBaIT8DK7PMPfQHyZr9Utf4npadi3RdEfeaN1BvvBxHCiCc</recordid><startdate>200607</startdate><enddate>200607</enddate><creator>Tabata, Ken-ichi</creator><creator>Satoh, Takefumi</creator><creator>Matsumoto, Kazumasa</creator><creator>Fujita, Tetsuo</creator><creator>Irie, Akira</creator><creator>Iwamura, Masatsugu</creator><creator>Yanagisawa, Nobuyuki</creator><creator>Matsuda, Daisuke</creator><creator>Muramoto, Masatoshi</creator><creator>Kadowaki, Kazuomi</creator><creator>Suyama, Kazuho</creator><creator>Shoji, Kiyoshi</creator><creator>Koh, Hideshige</creator><creator>Kawakami, Tatsuo</creator><creator>Okayasu, Isao</creator><creator>Egawa, Shin</creator><creator>Baba, Shiro</creator><general>THE JAPANESE UROLOGICAL ASSOCIATION</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200607</creationdate><title>8-MONTH NEOADJUVANT HORMONAL THERAPY BEFORE RADICAL PROSTATECTOMY FOR HIGH-RISK PROSTATE CANCER</title><author>Tabata, Ken-ichi ; Satoh, Takefumi ; Matsumoto, Kazumasa ; Fujita, Tetsuo ; Irie, Akira ; Iwamura, Masatsugu ; Yanagisawa, Nobuyuki ; Matsuda, Daisuke ; Muramoto, Masatoshi ; Kadowaki, Kazuomi ; Suyama, Kazuho ; Shoji, Kiyoshi ; Koh, Hideshige ; Kawakami, Tatsuo ; Okayasu, Isao ; Egawa, Shin ; Baba, Shiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2782-34f691b10b15d807d45391c704620dc446d85c1ffc05e4f2217da5dbd74249483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; jpn</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Androgen Antagonists - administration & dosage</topic><topic>Anilides - administration & dosage</topic><topic>Antineoplastic Agents, Hormonal - administration & dosage</topic><topic>biochemical failure</topic><topic>Biomarkers, Tumor - blood</topic><topic>Chemotherapy, Adjuvant</topic><topic>Goserelin - administration & dosage</topic><topic>high-risk prostate cancer</topic><topic>Humans</topic><topic>Leuprolide - administration & dosage</topic><topic>Male</topic><topic>Middle Aged</topic><topic>neoadjuvant hormonal therapy</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm Staging</topic><topic>Nitriles</topic><topic>Prospective Studies</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - therapy</topic><topic>Risk</topic><topic>Time Factors</topic><topic>Tosyl Compounds</topic><topic>Treatment Failure</topic><toplevel>online_resources</toplevel><creatorcontrib>Tabata, Ken-ichi</creatorcontrib><creatorcontrib>Satoh, Takefumi</creatorcontrib><creatorcontrib>Matsumoto, Kazumasa</creatorcontrib><creatorcontrib>Fujita, Tetsuo</creatorcontrib><creatorcontrib>Irie, Akira</creatorcontrib><creatorcontrib>Iwamura, Masatsugu</creatorcontrib><creatorcontrib>Yanagisawa, Nobuyuki</creatorcontrib><creatorcontrib>Matsuda, Daisuke</creatorcontrib><creatorcontrib>Muramoto, Masatoshi</creatorcontrib><creatorcontrib>Kadowaki, Kazuomi</creatorcontrib><creatorcontrib>Suyama, Kazuho</creatorcontrib><creatorcontrib>Shoji, Kiyoshi</creatorcontrib><creatorcontrib>Koh, Hideshige</creatorcontrib><creatorcontrib>Kawakami, Tatsuo</creatorcontrib><creatorcontrib>Okayasu, Isao</creatorcontrib><creatorcontrib>Egawa, Shin</creatorcontrib><creatorcontrib>Baba, Shiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nippon Hinyokika Gakkai zasshi</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tabata, Ken-ichi</au><au>Satoh, Takefumi</au><au>Matsumoto, Kazumasa</au><au>Fujita, Tetsuo</au><au>Irie, Akira</au><au>Iwamura, Masatsugu</au><au>Yanagisawa, Nobuyuki</au><au>Matsuda, Daisuke</au><au>Muramoto, Masatoshi</au><au>Kadowaki, Kazuomi</au><au>Suyama, Kazuho</au><au>Shoji, Kiyoshi</au><au>Koh, Hideshige</au><au>Kawakami, Tatsuo</au><au>Okayasu, Isao</au><au>Egawa, Shin</au><au>Baba, Shiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>8-MONTH NEOADJUVANT HORMONAL THERAPY BEFORE RADICAL PROSTATECTOMY FOR HIGH-RISK PROSTATE CANCER</atitle><jtitle>Nippon Hinyokika Gakkai zasshi</jtitle><addtitle>Jpn. j. urol</addtitle><date>2006-07</date><risdate>2006</risdate><volume>97</volume><issue>5</issue><spage>712</spage><epage>718</epage><pages>712-718</pages><issn>0021-5287</issn><eissn>1884-7110</eissn><abstract>(Purpose) To evaluate the clinicopathological outcomes of 8 months of neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy for high-risk prostate cancer. (Patients and Methods) A multi-institutional prospective trial was performed between July 2000 and May 2003 involving high-risk prostate cancer patients without metastasis, including 21 who received 8 months of NHT before radical prostatectomy. High-risk group was defined as clinical stage ≥T2c and/or prostate-specific antigen (PSA) >20ng/ml and/or Gleason score ≥8. PSA values were considered elevated (biochemical failure) if values of 0.1ng/ml or greater were obtained. (Results) Median of initial PSA levels before prostate biopsy was 27.6ng/ml (8.5-80.7ng/ml), and median of pre-operative PSA levels after NHT was 0.28ng/ml (0.02-4.2ng/ml). There were 5 patients (23.8%) with lower limit of PSA detection (less than 0.02ng/ml) in 8 months after NHT. The clinical T stage was T1c in 9 patients (42.9%), T2a-b in 8 patients (38.1%), T2c in 3 patients (14.3%), and T3a in 1 patient (4.8%). The median follow-up was 25 months (range 4 to 37). There were 2 patients (9.5%) in pT0, 5 patients (23.8%) with positive surgical margin, 5 patients (23.8%) with extracapsular extension (ECE) and 3 patients (14.3%) with seminal vesicle involvement (SVI). Biochemical failure was occurred in 9 of 21 (42.9%) including of one pT0. Range of time to postoperative biochemical failure was 2 to 25 months (median 6 months) and most of biochemical failure was found within 12 months after surgery. Biochemical failure rate was significantly higher in patient with positive SVI (p=0.0308) and higher in patients with pre-operative PSA levels of more than 0.1ng/ml (p=0.0836), positive ECE (p=0.0545) and positive surgical margin (p=0.0545). (Conclusion) Biochemical failure was frequent after this combined treatment, even in a pT0 case. Long-term follow-up of patients is needed to assess the impact of this therapy on mortality.</abstract><cop>Japan</cop><pub>THE JAPANESE UROLOGICAL ASSOCIATION</pub><pmid>16898594</pmid><doi>10.5980/jpnjurol1989.97.712</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Androgen Antagonists - administration & dosage Anilides - administration & dosage Antineoplastic Agents, Hormonal - administration & dosage biochemical failure Biomarkers, Tumor - blood Chemotherapy, Adjuvant Goserelin - administration & dosage high-risk prostate cancer Humans Leuprolide - administration & dosage Male Middle Aged neoadjuvant hormonal therapy Neoadjuvant Therapy Neoplasm Staging Nitriles Prospective Studies Prostate-Specific Antigen - blood Prostatectomy Prostatic Neoplasms - diagnosis Prostatic Neoplasms - pathology Prostatic Neoplasms - therapy Risk Time Factors Tosyl Compounds Treatment Failure |
| title | 8-MONTH NEOADJUVANT HORMONAL THERAPY BEFORE RADICAL PROSTATECTOMY FOR HIGH-RISK PROSTATE CANCER |
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