Cytoreductive Radical Prostatectomy in Oligometastatic Prostate Cancer: Single-Centre Experience

This study aims to evaluate the oncological outcomes, functional recovery and overall satisfaction following cytoreductive radical prostatectomy (CRP) in patients with oligometastatic prostate cancer treated at a single tertiary-care centre.

Between 2021 and 2024, 12 patients with clinically and radiologically confirmed oligometastatic prostate cancer (≤5 bone lesions, no visceral metastases) underwent open retropubic CRP after 6 months of neoadjuvant androgen deprivation therapy (ADT) and targeted radiotherapy to metastatic sites. Postoperatively, all patients received adjuvant ADT for 2 years. Perioperative details, pathological findings and functional outcomes including continence, erectile function and biochemical recurrence (BCR) were recorded prospectively and analysed with descriptive statistics.

The mean age was 60 years (range 55-68), mean operative time 200 minutes and mean blood loss 550 mL. Final histopathology showed organ-confined (pT2) disease in all patients; two (16.7%) had positive surgical margins, and four (33.3%) had nodal involvement. Continence was achieved in 10 patients (83%) at 1 year, while potency was regained in all 10 who underwent nerve-sparing surgery within 12 months. No patient developed biochemical recurrence at a mean follow-up of 25 months. Ten patients (83%) reported complete satisfaction with the procedure.

Cytoreductive radical prostatectomy appears to be a safe and feasible component of multimodal therapy for carefully selected patients with oligometastatic prostate cancer. In this limited series, acceptable perioperative morbidity, encouraging early oncological outcomes and good functional recovery were observed, supporting its potential role in comprehensive disease control.