New surgical approaches for clinically high-risk or metastatic prostate cancer

Paolo Dell’Oglio, Armando Stabile, G Gandaglia, E Zaffuto, Nicola Fossati, M Bandini, N Suardi, PI Karakiewicz, SF Shariat, F Montorsi, A Briganti

Research output: Contribution to journalArticlepeer-review

Abstract

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Introduction: A considerable number of individuals with prostate cancer (PCa) still harbor locally-advanced and metastatic disease. Although such men were initially not considered eligible for local treatment, the role of radical prostatectomy (RP) has been recently reassessed. Areas covered: This review analyses currently published evidences regarding new surgical approaches for clinically high-risk PCa individuals, as well as the role of cytoreductive surgery in the metastatic setting. The role of robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection will be evaluated with regards to perioperative, oncologic, as well as functional outcomes. Expert commentary: RARP is a feasible approach in PCa patients regardless of the presence of high-risk disease features and can achieve optimal short-term oncologic outcomes and acceptable short/intermediate-term functional outcomes, that are comparable to those reported for open RP. Extended pelvic lymph node dissection can be performed in this setting and should be recommended for all high-risk PCa patients. The overall rate of complications in contemporary men treated with RARP for high-risk disease is not negligible. Cytoreduction in the oligo-metastatic setting is feasible and relatively safe, although evidence is scarce to recommend its widespread adoption. In consequence, longer follow-up data and, ideally, randomized controlled trials are needed. © 2017 Informa UK Limited, trading as Taylor & Francis Group.
Original languageEnglish
Pages (from-to)1013-1031
Number of pages19
JournalExpert Review of Anticancer Therapy
Volume17
Issue number11
DOIs
Publication statusPublished - 2017

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