2026 Beijing Young Urologic Oncology Physicians Academic Exchange Conference
Editor’s Note: From January 10 to 11, 2026, the Beijing Young Urologic Oncology Physicians Academic Exchange Conference concluded successfully in Beijing. The meeting brought together leading experts and young physicians in urologic oncology to discuss cutting-edge scientific advances and clinical challenges, with the goal of fostering innovation and professional development among emerging clinicians.At present, the role of neoadjuvant therapy in prostate cancer remains an area of ongoing debate and clinical trade-offs. Taking this opportunity, Oncology Frontier – Urology Frontier invited Professor Yonghong Li from the Sun Yat-sen University Cancer Center to explore the current status, challenges, and future directions of neoadjuvant therapy for locally advanced prostate cancer (LAPC) in China, offering insights for urologic specialists.
Professor Yonghong Li’s Featured Presentation
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Oncology Frontier – Urology Frontier
What is the clinical value of neoadjuvant therapy for patients with locally advanced prostate cancer?
Professor Yonghong Li: This is an excellent question. In China, prostate-specific antigen (PSA) screening has not yet been widely implemented, meaning many patients are diagnosed at a high-risk or locally advanced stage. For these patients, proceeding directly to surgery can be technically challenging. As a result, preoperative neoadjuvant therapy has become a widely accepted practice in China.
The primary value of neoadjuvant therapy lies in its ability to reduce prostate volume and tumor burden, thereby converting patients who were initially poor surgical candidates into operable cases. In other words, it creates surgical opportunities for more patients, which is highly meaningful in the Chinese clinical context.
However, every treatment has two sides. While neoadjuvant therapy may improve surgical feasibility, it can also complicate postoperative risk assessment and treatment planning. For example, treatment-induced pathological downstaging, lower positive margin rates, and significantly reduced PSA levels may obscure the patient’s true underlying risk. As a result, even patients who achieve favorable pathological or biochemical outcomes after neoadjuvant therapy require close and long-term follow-up.
I would also like to emphasize that for high-risk LAPC, local treatment options are not limited to surgery—radiotherapy is equally effective. Internationally, surgery and radiotherapy play comparable roles, and in some cases radiotherapy is more widely used. Therefore, treatment decisions should be individualized, taking into account patient characteristics, institutional resources, and the optimal integration of neoadjuvant therapy within a comprehensive treatment strategy.
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Oncology Frontier – Urology Frontier
PSA decline and MRI tumor shrinkage are commonly used to assess response to neoadjuvant therapy, yet some patients still experience postoperative recurrence. How do you view the predictive role of emerging technologies such as PSMA-PET and ctDNA monitoring in the neoadjuvant setting?
Professor Yonghong Li: Currently, we primarily rely on PSA levels and conventional imaging—especially multiparametric MRI (mpMRI)—to evaluate response to neoadjuvant therapy and guide subsequent treatment decisions. However, we do observe cases in which patients show excellent postoperative pathology and PSA results, yet paradoxically face higher risks of biochemical or clinical recurrence than patients who did not receive neoadjuvant therapy.
This raises an important question: Can we better predict recurrence risk in this population?
PSMA-PET is indeed a more sensitive modality for detecting micrometastatic disease. At initial diagnosis, it can reveal metastatic lesions that conventional imaging may miss. After treatment, its sensitivity may be somewhat reduced, but it still retains advantages over standard imaging. Therefore, for patients at high risk of recurrence, PSMA-PET remains a valuable diagnostic and prognostic tool.
As for circulating tumor DNA (ctDNA), its use in localized prostate cancer remains limited, with most applications currently focused on metastatic disease. In localized settings, PSA remains a reliable and practical biomarker, and ctDNA has not yet been widely adopted in early-stage clinical practice.
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Oncology Frontier – Urology Frontier
The optimal duration of neoadjuvant therapy (typically 3–6 months) is not standardized, and prolonged treatment may delay surgery. How should clinicians balance tumor downsizing benefits with surgical timing?
Professor Yonghong Li: There is indeed no universally standardized duration for neoadjuvant therapy. At present, a treatment window of approximately 3–9 months before surgery or radiotherapy is generally considered appropriate.
Most prostate cancers are hormone-sensitive at initial diagnosis, and patients typically remain responsive within this timeframe. Therefore, this period is unlikely to compromise the timing of definitive local treatment due to early resistance.
That said, some patients demonstrate suboptimal response to neoadjuvant therapy. In such cases, clinicians should closely monitor PSA trends and imaging changes, dynamically assess treatment response, and adjust the treatment plan accordingly to avoid unnecessary delays.
Many international multicenter trials adopt a 6-month neoadjuvant duration, and taken together, a 3–9 month window appears to be a reasonable balance that maximizes tumor control while minimizing the risk of missing the optimal surgical opportunity.
Professor Yonghong Li
