Role of surgery in oligometastatic prostate cancer

Jenjitranant, Pocharapong; Touijer, Karim

doi:10.1016/j.prnil.2019.10.001

Cited by 15 publications

(8 citation statements)

References 74 publications

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“…While discussion regarding optimal management of men with biochemical failure is ongoing, there is general agreement that accurate identification of disease location and extent is key to determining the most appropriate management (Figure 14). Several trials have evaluated the role of surgery, radiation or a combination of ablative procedures, in men with localized, oligometastatic or low-volume disease [17][18][19][20]. Further, studies have shown high performance of PSMA-targeted PET in this patient population.…”

Section: Staging Of Biochemical Recurrencementioning

confidence: 99%

Canadian Urological Association best practice report: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and PET/magnetic resonance (MR) in prostate cancer

Shaygan¹,

Zukotynski²,

Bénard³

et al. 2021

CUAJ

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Prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) is increasingly being used worldwide as part of the clinical workup for men with prostate cancer. With high overall accuracy for the detection of prostate cancer, PSMA-targeted PET has an increasingly established role in the setting of biochemical failure after primary therapy and an evolving role in the setting of initial disease staging; its utility for guiding management in the setting of metastatic disease is less clear. Although the specificity is high, familiarization with potential pitfalls in the interpretation of PSMA-targeted PET, including knowledge of the causes for false positive and negative examinations, is critical. The aim of this article is to provide an illustrative discussion of the current and evolving clinical indications for PSMA-targeted PET, as well as a review of physiologic radiopharmaceutical biodistribution and potential imaging pitfalls.

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Section: Staging Of Biochemical Recurrencementioning

confidence: 99%

Canadian Urological Association best practice report: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and PET/magnetic resonance (MR) in prostate cancer

Shaygan¹,

Zukotynski²,

Bénard³

et al. 2021

CUAJ

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“…Роль циторедуктивной хирургии широко обсуждается в лечении таких опухолей, как распространенный рак яичников, рак молочной железы и рак почки [13][14][15]. Однако место для циторедуктивной хирургии мРПЖ остается до конца не определенным, как и профиль тех пациентов, которые получат максимальную выгоду от такого подхода [16].…”

Section: Discussionunclassified

“…Несмотря на то что в этой серии был показан низкий уровень серьезных осложнений и хороший функциональный результат, авторы сделали вывод о необходимости индивидуального подхода к пациентам с мРПЖ в рамках мультимодального лечения [18]. Говоря о циторедуктивном хирургическом лечении мРПЖ, следует отметить еще одно преимущество такого подхода, а именно предотвращение проявлений местного прогрессирования: дизурии, макрогематурии, задержки мочеиспускания, болевого синдрома [16].…”

Section: Discussionunclassified

First experiment study in cytoreductive prostatectomy in patients with oligo-metastatic prostate cancer following neoadjuvant chemohormonotherapy

et al. 2021

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Background. Nowadays there is no consensus on application of cytoreductive prostatectomy in a complex therapy in patients with oligo-metastatic prostate cancer.Study objective: assessment of short-term results of neoadjuvant chemohormonotherapy followed by cytoreductive prostatectomy in patients with oligo-metastatic prostate cancer.Materials and methods. Cytoreductive prostatectomy was performed in 7 patients with oligometastatic prostate cancer.Results. Postoperative complications in 3 (42.9 %) out of 7 treated patients were classified as grade IIIb according to Clavien-Dindo scale. Post-surgical analysis of prostate tissue samples showed therapeutic pathomorphism of grade II in 3 patients (42.9 %), grade III in 1 patient (14.3 %) and grade IV in another patient (14.3 %). Urinary continence regained in all the patients. Average postoperative supervision period took 12 months. Disease progression was diagnosed in 1 patient (14.3 %).Conclusion. Combined application of neoadjuvant chemohormonotherapy followed by cytoreductive prostatectomy can be considered as an alternative method of treatment in a properly selected group of patients with oligo-metastatic prostate cancer.

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“…Radical prostatectomy (RP) and radiation therapy (RT) combined with androgen deprivation therapy (ADT) are currently the approved standards of care for localized/locally advanced prostate cancer (PCa). Even after debates on the over-treatment triggered by prostate-specific antigen (PSA) based screening strategy for the general population, increasing evidence over the past decade supports the oncologic efficacy of RP even in high-risk disease [ 1 2 ]. However, there is a paucity of data concerning the role of radical surgery in elderly patients (≥75 y), mainly because contemporary guidelines limit the application of RP in men with a life expectancy of <10 years [ 3 4 ].…”

Section: Introductionmentioning

confidence: 99%

A comparison of the survival outcomes of robotic-assisted radical prostatectomy and radiation therapy in patients over 75 years old with non-metastatic prostate cancer: A Korean multicenter study

Park

et al. 2021

Investig Clin Urol

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Purpose To compare overall survivals (OSs) and cancer-specific survivals (CSSs) after robotic-assisted radical prostatectomy (RARP) and radiation therapy (RT), the latter of which has long been recommended primarily for elderly patients (≥75 years) with non-metastatic prostate cancer (PCa), given the Korean male life span of 79.7 years (2018). Materials and Methods Retrospective data for aged ≥75 years who underwent RARP or RT at seven tertiary hospitals were analyzed. To account for indication-related bias, inverse probability of treatment-weighting (IPTW) was applied before and after Cox regression. Results Of the 1,110 study subjects, 883 underwent RARP and 227 RT from 2007 to 2016. The differences between groups including the age (≥80 y; 25.4% vs. 32.8%; p=0.034), concomitant diabetes (14.9% vs. 22.9%; p=0.007), coronary heart disease (3.5% vs. 7.5%; p=0.015), and PCa risk stratification (high-risk; 18.2% vs. 59.7%; p<0.001) were balanced after IPTW. During a mean follow-up of 74.5 months, OSs (91.9% vs. 91.0%) and CSSs (97.8% vs. 98.0%) were similar. After IPTW, overall mortality was associated with diabetes (hazard ratio [HR], 2.273; p<0.0001) and inversely with low-risk PCa (HR, 0.314; p<0.0001), the last of which was solely associated with cancer-specific mortality (HR, 0.245; p=0.0005). The implementation of local treatment between RARP and RT demonstrated no impact on survival, for whole and high-risk populations. Conclusions Even aged over 75 years, patients who underwent RARP for non-metastatic PCa had similar survival with RT regardless of risk stratification. However, the survival needs to be weighed with the morbidity of local treatment in a future study.

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Role of surgery in oligometastatic prostate cancer

Cited by 15 publications

References 74 publications

Canadian Urological Association best practice report: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and PET/magnetic resonance (MR) in prostate cancer

Canadian Urological Association best practice report: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and PET/magnetic resonance (MR) in prostate cancer

First experiment study in cytoreductive prostatectomy in patients with oligo-metastatic prostate cancer following neoadjuvant chemohormonotherapy

A comparison of the survival outcomes of robotic-assisted radical prostatectomy and radiation therapy in patients over 75 years old with non-metastatic prostate cancer: A Korean multicenter study

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