Abstract
OBJECTIVE: This study aims to systematically evaluate the impact of neoadjuvant therapy (NHT) on the efficacy and safety of laparoscopic radical prostatectomy (LRP). METHODS: We conducted a search of PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database for cohort studies on neoadjuvant therapy combined with LRP for prostate cancer versus standard treatment for prostate cancer, up to February 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed using RevMan 5.4.1 software. RESULTS: A total of 14 studies were included. The results of the meta-analysis showed that compared to standard LRP, NHT combined with LRP can reduce the rate of positive surgical margins, biochemical recurrence rate, blood loss, and duration of catheterization. Subgroup analysis indicated that preoperative NHT combined with RALP demonstrated significant improvements in surgical time, blood loss, and positive surgical margins compared to traditional LRP. CONCLUSION: Neoadjuvant therapy can improve tumor control outcomes for LRP, but may increase the risk of postoperative complications. NHT combined with RALP can be considered as a preferred treatment option in the surgical management of prostate cancer (PCa). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12672-025-04364-4.