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Current concepts in oligometastatic prostate cancer: Is there a role for radical prostatectomy?

Jose Marenco1, Prasanna Sooriakumaran2

  • 1University College London Hospital. NHS Foundation Trust. London. UK.

Archivos Espanoles De Urologia
|March 12, 2019
PubMed
Abstract

Insights

Local treatment may benefit select prostate cancer patients with limited metastases. Research is ongoing to determine if primary site treatment improves outcomes in oligometastatic prostate cancer, potentially changing standard care.

Area of Science:

  • Urology
  • Oncology
  • Surgical Oncology

Background:

  • Prostate cancer is a leading malignancy in men, with metastatic disease occurring in approximately 4% of cases despite PSA screening.
  • Systemic therapy is the current standard for metastatic prostate cancer, while cytoreductive surgery is established for other metastatic solid tumors.

Purpose of the Study:

  • To review the literature evaluating the potential benefits of local treatment (LT) to the primary tumor in patients with metastatic prostate cancer.
  • To assess the role of LT in the context of oligometastatic prostate cancer.

Main Methods:

  • A comprehensive review of existing literature was conducted.
  • The focus was on studies investigating local treatment for primary prostate cancer in the setting of metastatic disease.

Main Results:

  • Local treatment of primary tumors has shown oncological and symptomatic benefits in other cancers.
  • Surgery has demonstrated a reduction in symptomatic progression for metastatic prostate cancer patients.

Conclusions:

  • The role of primary site surgery or metastasis-directed treatment is under investigation for oligometastatic prostate cancer.
  • Retrospective data support ongoing randomized trials, with new imaging potentially influencing this paradigm shift.
  • More data are required before local treatment can be recommended as standard of care for metastatic prostate cancer.
Keywords:
Cáncer de próstata oligometastásicoCáncer de próstataOligometastatic prostate cancerProstate cancerProstatectomía radicalRadical prostatectomy

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