Does Radical Local Treatment in Oligometastatic Prostate Cancer Improve Overall Survival: A Systematic Review and...

Area of Science:

• Oncology
• Urology
• Radiotherapy

Background:

• Oligometastatic prostate cancer (OMPC) presents a unique clinical challenge.
• Determining the optimal treatment strategy for OMPC is crucial for improving patient outcomes.
• Radical local treatment (RLT) encompasses both radical prostatectomy (RP) and external beam radiotherapy (EBRT).

Approach:

• A meta-analysis was conducted on randomized controlled trials (RCTs) comparing RLT with standard of care for OMPC.
• Data from MEDLINE and CENTRAL databases were systematically reviewed until May 2023.
• Overall survival (OS) was the primary endpoint, with a minimum follow-up of 4 years.

Key Points:

• RLT demonstrated a significant improvement in OS for OMPC patients (HR 0.643, P < .001).
• External beam radiotherapy (EBRT) data included 520 patients, while radical prostatectomy (RP) data involved 85 patients.
• Pooled grade 3-4 bowel and bladder toxicity was 4.5%, with no significant difference in Health-Related Quality of Life between groups.
• The certainty of evidence was high, with low risk of bias across included studies.

Conclusions:

• RLT, especially EBRT, offers significant survival benefits for OMPC.
• Findings suggest incorporating EBRT into the standard treatment approach for OMPC.
• Further research with larger sample sizes, particularly for RP, is warranted.