新辅助治疗是否能为晚期前列腺癌（PCa）带来生存获益仍不确定。既往回顾性和II期临床研究使用新辅助治疗（包括雄激素剥夺疗法联合新一代雄激素受体信号抑制剂或化疗）的主要终点是病理降期、无进展生存期、前列腺特异性抗原缓解和局部症状改进。据我们所知，尚无研究探讨新辅助治疗在提高不可切除原发性前列腺癌病例的手术切除率方面的有效性和安全性。我们首先设计这项回顾性研究是为了评估阿帕鲁胺作为新辅助治疗在提高根治性前列腺切除术（RP）的可切除率方面的潜在价值。我们最初报告了 7 名原发灶不可切除的患者接受了中位阿帕鲁胺新辅助治疗 4 个月，并且全部成功接受了 RP 治疗。我们的研究支持阿帕他胺作为新辅助治疗，有助于提高RP的成功率，且未显着增加围手术期并发症，新辅助治疗是可控的。我们的研究结果的临床价值和生存获益仍需要进一步的临床研究来证实。版权所有 © 2023 Wei、Zhang、Zhong、Chen、Chen、Yang、Lin、Li、Ye、Chen 和 Zhu。

Whether neoadjuvant therapy confers a survival benefit in advanced prostate cancer (PCa) remains uncertain. The primary endpoints of previous retrospective and phase II clinical studies that used neoadjuvant therapy, including androgen deprivation therapy combined with new-generation androgen receptor signaling inhibitors or chemotherapy, were pathological downstaging, progression-free survival, prostate-specific antigen relief, and local symptom improvement. To the best of our knowledge, no studies have explored the efficacy and safety of neoadjuvant therapy in improving the surgical resection rate in cases of unresectable primary tumors of PCa. We first designed this retrospective study to evaluate the potential value of apalutamide as neoadjuvant therapy in improving the resectability rate of radical prostatectomy (RP). We initially reported 7 patients with unresectable primary lesions who underwent neoadjuvant apalutamide treatment for a median of 4 months, and all of them successfully underwent RP treatment. Our study supported apalutamide as neoadjuvant therapy, which helped improve RP's success rate and did not significantly increase perioperative complications, and the neoadjuvant therapy was controllable. Our findings' clinical value and benefit for survival still need further clinical research to confirm.Copyright © 2023 Wei, Zhang, Zhong, Chen, Chen, Yang, Lin, Li, Ye, Chen and Zhu.