Hisanori TANIGUCHI, Junichi IKEDA, Yuki MASUO, Hidefumi KINOSHITA
Urology Research & Practice - 2026;52(2026):1-5
Objective: Neoadjuvant androgen deprivation therapy (ADT) is commonly administered before robot-assisted radical prostatectomy (RARP) in selected patients with localized prostate cancer, particularly those with high-risk disease. Despite its potential oncologic benefits, the association of neoadjuvant ADT with postoperative urinary function and health-related quality of life remains unclear. Therefore, this study aims to evaluate the association between neoadjuvant ADT and functional recovery following RARP. Methods: Consecutive patients who underwent RARP between January 1, 2022, and December 31, 2024, were retrospectively reviewed and categorized based on neoadjuvant ADT status. Urinary continence (<=1 pad/d), Expanded Prostate Cancer Index Composite urinary domain score, Functional Assessment of Cancer Therapy- General score, and Functional Assessment of Cancer Therapy-Prostate score were assessed longitudinally. Urinary continence recovery was analyzed using the Kaplan-Meier method, and longitudinal patient-reported outcomes were evaluated using linear mixed-effects models. Results: Among 327 eligible patients, 58 received neoadjuvant ADT. Urinary continence recovery was comparable between the groups (log-rank P = .251). Expanded Prostate Cancer Index Composite urinary domain scores decreased immediately after surgery and improved over time (P for time <.001). Neoadjuvant ADT (P = .181) and the time-by-treatment interaction (P = .557) were not significantly associated with postoperative urinary function. Similarly, longitudinal Functional Assessment of Cancer Therapy-General and Functional Assessment of Cancer Therapy-Prostate scores were comparable between the groups. Conclusion: Neoadjuvant ADT is not associated with delayed urinary continence recovery or poorer health-related quality of life after RARP, supporting its use in appropriately selected patients without evidence of compromised postoperative functional recovery.
