{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:08:56Z","timestamp":1789848536873,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82472911"],"award-info":[{"award-number":["82472911"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate the impact of neoadjuvant hormonal therapy (Neo\u2010HT) on postoperative pathological and prostate\u2010specific antigen (PSA) outcomes after radical prostatectomy (RP) and oncological outcomes in patients with favorable postoperative outcomes (pT0\u20102N0, negative surgical margin and undetectable PSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1099 prostate cancer (PCa) patients who underwent RP were divided into the direct RP group or the Neo\u2010RP group (Neo\u2010HT before RP). We compared the proportions achieving favorable postoperative outcomes. Oncological endpoints included biochemical progression\u2010free survival (bPFS), local recurrence\u2010free survival (LRFS), and metastasis\u2010free survival (MFS). Predictors of biochemical recurrence (BCR) were identified using multivariable Cox regression. Propensity score matching (PSM) was applied to balance baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Neo\u2010HT increased the proportions achieving favorable postoperative outcomes among both low\u2010to\u2010intermediate and high\u2010risk patients (42.02% vs. 23.63%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among 362 patients with favorable postoperative outcomes, unadjusted 3\u2010year bPFS was worse in the Neo\u2010RP group (81.5% vs. 93.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), with similar patterns for LRFS and MFS. Baseline PSA\u2009&gt;\u200920\u2009ng\/ml, Gleason score 8\u201310, and cT2c\u20104 were independent predictors of BCR, and no statistically significant differences in bPFS, LRFS, or MFS were observed in the PSM cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neo\u2010HT enables more PCa patients to achieve favorable postoperative outcomes. Among patients with favorable postoperative outcomes, those with high\u2010risk baseline features are more likely to experience BCR irrespective of Neo\u2010HT. The apparent improvements in postoperative pathological and PSA outcomes after Neo\u2010HT may obscure recurrence risk, underscoring the need to incorporate baseline characteristics into postoperative risk stratification and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70250","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:00:13Z","timestamp":1789848013000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neoadjuvant Hormonal Therapy Before Radical Prostatectomy: Favorable Pathological and PSA Outcomes Do Not Guarantee Favorable Oncological Outcomes"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5612-258X","authenticated-orcid":false,"given":"Junliang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4464-7434","authenticated-orcid":false,"given":"Yuanwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5319-4633","authenticated-orcid":false,"given":"Xinyang","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diwei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingbo","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8211-2721","authenticated-orcid":false,"given":"Yijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Pathology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangjian","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6679-8380","authenticated-orcid":false,"given":"Zhenyu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1795-7242","authenticated-orcid":false,"given":"Yonghong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"issue":"3","key":"e_1_2_11_2_1","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray F.","year":"2024","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1464-410X.2009.09134.x","article-title":"Long\u2010Term Data on the Survival of Patients With Prostate Cancer Treated With Radical Prostatectomy in the Prostate\u2010Specific Antigen Era","volume":"106","author":"Isbarn H.","year":"2010","journal-title":"BJU International"},{"issue":"1","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.eururo.2019.01.048","article-title":"Persistent Prostate\u2010Specific Antigen After Radical Prostatectomy and its Impact on Oncologic Outcomes","volume":"76","author":"Preisser F.","year":"2019","journal-title":"European Urology"},{"issue":"2","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.eururo.2016.05.008","article-title":"Robot\u2010Assisted Radical Prostatectomy and Extended Pelvic Lymph Node Dissection in Patients With Locally\u2010Advanced Prostate Cancer","volume":"71","author":"Gandaglia G.","year":"2017","journal-title":"European 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Categories According to Surgical Margins Status, Pathological Stage and Gleason Score","volume":"20","author":"Schiavina R.","year":"2013","journal-title":"International Journal of Urology"},{"issue":"4","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/bju.12342","article-title":"Prognosis of Patients With Pelvic Lymph Node (LN) Metastasis After Radical Prostatectomy: Value of Extranodal Extension and Size of the Largest LN Metastasis","volume":"114","author":"Passoni N. M.","year":"2014","journal-title":"BJU International"},{"issue":"20","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1200\/JCO.21.02800","article-title":"Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death","volume":"40","author":"Tilki D.","year":"2022","journal-title":"Journal of Clinical Oncology"},{"issue":"5","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.eururo.2019.07.001","article-title":"Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients With Positive Margins or Extracapsular Extension","volume":"76","author":"Hackman G.","year":"2019","journal-title":"European Urology"},{"issue":"7","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.annonc.2024.03.010","article-title":"Timing of Radiotherapy (Rt) After Radical Prostatectomy (RP): Long\u2010Term Outcomes in the RADICALS\u2010RT Trial (NCT00541047)","volume":"35","author":"Parker C. C.","year":"2024","journal-title":"Annals of Oncology"},{"key":"e_1_2_11_13_1","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. Version 4.2026. National Comprehensive Cancer Network; 2026."},{"issue":"6","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1159\/000020366","article-title":"4\u2010Year Follow\u2010Up Results of a European Prospective Randomized Study on Neoadjuvant Hormonal Therapy Prior to Radical Prostatectomy in T2\u20103N0M0 Prostate Cancer","volume":"38","author":"Schulman C. C.","year":"2000","journal-title":"European Urology"},{"issue":"3","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1159\/000077113","article-title":"Neoadjuvant Hormone Treatment With Leuprolide Acetate Depot 3.75 mg and Cyproterone Acetate, Before Radical Prostatectomy: A Randomized Study","volume":"72","author":"Prezioso D.","year":"2004","journal-title":"Urologia Internationalis"},{"issue":"9","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1158\/1078-0432.CCR-16-1357","article-title":"Neoadjuvant Enzalutamide Prior to Prostatectomy","volume":"23","author":"Montgomery B.","year":"2017","journal-title":"Clinical Cancer Research"},{"issue":"4","key":"e_1_2_11_17_1","article-title":"Neo\u2010Adjuvant and Adjuvant Hormone Therapy for Localised and Locally Advanced Prostate Cancer","volume":"2006","author":"Kumar S.","year":"2006","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"4","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.4103\/aja.aja_96_20","article-title":"Neoadjuvant Hormone Therapy for Patients With High\u2010Risk Prostate Cancer: A Systematic Review and Meta\u2010Analysis","volume":"23","author":"Liu W.","year":"2021","journal-title":"Asian Journal of Andrology"},{"issue":"2","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1158\/1078-0432.CCR-08-1754","article-title":"Disseminated Tumor Cells in Prostate Cancer Patients After Radical Prostatectomy and Without Evidence of Disease Predicts Biochemical Recurrence","volume":"15","author":"Morgan T. M.","year":"2009","journal-title":"Clinical Cancer Research"},{"issue":"6","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.eururo.2025.01.015","article-title":"Long\u2010Term Outcomes and Prognostic Impact of Residual Cancer Burden After Intensified Neoadjuvant Therapy in High\u2010Risk Prostate Cancer","volume":"87","author":"Ravi P.","year":"2025","journal-title":"European Urology"},{"issue":"3","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.euo.2025.12.005","article-title":"Final Results of the Randomised Phase 2 Trial of Neoadjuvant Degarelix With or Without Apalutamide Prior to Radical Prostatectomy for High\u2010Risk Prostate Cancer (ARNEO)","volume":"9","author":"Giesen A.","year":"2026","journal-title":"European Urology Oncology"},{"issue":"3","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.xcrm.2025.102018","article-title":"Neoadjuvant Fuzuloparib Combined With Abiraterone for Localized High\u2010Risk Prostate Cancer (FAST\u2010PC): A Single\u2010Arm Phase 2 Study","volume":"6","author":"Zhang T.","year":"2025","journal-title":"Cell Reports Medicine"},{"issue":"12","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1038\/s41585-021-00514-9","article-title":"Neoadjuvant Hormonal Therapy before Radical Prostatectomy in High\u2010Risk Prostate Cancer","volume":"18","author":"Devos G.","year":"2021","journal-title":"Nature Reviews Urology"},{"issue":"2","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/21681805.2022.2034941","article-title":"Comparison of Short\u2010Term and Long\u2010Term Neoadjuvant Hormone Therapy Prior to Radical Prostatectomy: A Systematic Review and Meta\u2010Analysis","volume":"56","author":"Katayama S.","year":"2022","journal-title":"Scandinavian Journal of Urology"},{"issue":"2","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S0022-5347(05)65971-X","article-title":"Randomized Comparative Study of 3 Versus 8\u2010month Neoadjuvant Hormonal Therapy before Radical Prostatectomy: Biochemical and Pathological Effects","volume":"166","author":"Gleave M. E.","year":"2001","journal-title":"Journal of Urology"},{"issue":"6","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.eururo.2022.09.009","article-title":"ARNEO: A Randomized Phase II Trial of Neoadjuvant Degarelix With or Without Apalutamide Prior to Radical Prostatectomy for High\u2010Risk Prostate Cancer","volume":"83","author":"Devos G.","year":"2023","journal-title":"European Urology"},{"issue":"1","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/JU.0000000000001702","article-title":"Results of a Randomized Phase II Trial of Intense Androgen Deprivation Therapy Prior to Radical Prostatectomy in Men With High\u2010Risk Localized Prostate Cancer","volume":"206","author":"McKay R. R.","year":"2021","journal-title":"Journal of Urology"},{"issue":"11","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1200\/JCO.18.01777","article-title":"Evaluation of Intense Androgen Deprivation Before Prostatectomy: A Randomized Phase II Trial of Enzalutamide and Leuprolide With or Without Abiraterone","volume":"37","author":"McKay R. R.","year":"2019","journal-title":"Journal of Clinical Oncology"},{"issue":"26","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"3042","DOI":"10.1200\/JCO.20.00315","article-title":"Cancer and Leukemia Group B 90203 (Alliance): Radical Prostatectomy With or Without Neoadjuvant Chemohormonal Therapy in Localized, High\u2010Risk Prostate Cancer","volume":"38","author":"Eastham J. A.","year":"2020","journal-title":"Journal of Clinical Oncology"},{"issue":"6","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1056\/NEJMoa2603878","article-title":"Perioperative Apalutamide in High\u2010Risk Localized Prostate Cancer","volume":"395","author":"Taplin M. E.","year":"2026","journal-title":"New England Journal of Medicine"},{"issue":"4","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.eururo.2019.05.010","article-title":"Clinical and Biological Characterisation of Localised High\u2010Risk Prostate Cancer: Results of a Randomised Preoperative Study of a Luteinising Hormone\u2010Releasing Hormone Agonist With or Without Abiraterone Acetate Plus Prednisone","volume":"76","author":"Efstathiou E.","year":"2019","journal-title":"European Urology"},{"issue":"10","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.2967\/jnumed.122.265368","article-title":"The Association Between [(68)Ga]PSMA PET\/CT Response and Biochemical Progression in Patients With High\u2010Risk Prostate Cancer Receiving Neoadjuvant Therapy","volume":"64","author":"Chen M.","year":"2023","journal-title":"Journal of Nuclear Medicine"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70250","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pros.70250","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:00:18Z","timestamp":1789848018000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":31,"alternative-id":["10.1002\/pros.70250"],"URL":"https:\/\/doi.org\/10.1002\/pros.70250","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]},"assertion":[{"value":"2026-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pros.70250"}}