Oncological Outcome of Cytoreductive Radical Prostatectomy in Prostate Cancer Patients With Bone Oligometastases

• Published in: Urology (Ridgewood, N.J.) N.J.), 2019-09, Vol.131, p.166-175
• Main Authors: Lan, Tian, Chen, Ye, Su, QinJun, Ye, JianJun
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bone Neoplasms - secondary; Cohort Studies; Cytoreduction Surgical Procedures; Humans; Male; Middle Aged; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Retrospective Studies; Treatment Outcome
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2019.03.040

To explore the role of cytoreductive radical prostatectomy (CRP) for locally resectable and distant oligometastatic prostate cancer (CaP). Oligometastases were defined as the presence of 5 or fewer metastatic lesions detected on 99mTc bone scan and no suspicious visceral involvement at pretreatment imaging. Clinical data on 111 consecutive patients who were diagnosed as oligometastatic CaP in our center from 2005 to 2016 was retrospectively collected. In this retrospective cohort study, 35 patients underwent CRP and androgen deprivation therapy, and 76 patients underwent androgen deprivation therapy alone. Oncological outcomes were analyzed by employing Kaplan-Meier method. The median follow-up of both groups was 35 months. In whole cohort analyses, prostate-specific antigen (PSA) decrease velocity (P = .167), PSA half-time (P = .263), and PSA nadir (P = .196) were not significantly different between 2 groups. Meanwhile, the differences in oncological outcomes between 2 groups did not reach statistical significance with regard to PSA relapse-free survival (P = .184), clinical progression-free survival (P = .118), and cancer-specific survival (P = .773). In addition, similar results were also observed in prespecified subgroup analyses (lower PSA group [0-100 ng/mL, P = .543], lower Gleason score group [6-7, P = .266], lower clinical T stage group [2-3 stage, P = .962], lower radiological N stage group [0 stage, P = .364]). In our study, significant benefit from CRP has not been detected in patients with oligometastatic CaP. Facing current trend, it demands deliberate consideration to select candidates for cytoreductive surgery, and the selection criteria should be further refined by incorporating additional prognostic factors.