The oncologic role of local treatment in primary metastatic prostate cancer

Pirus Ghadjar, Alberto Briganti, Peter J L De Visschere, Jurgen J. Fütterer, Gianluca Giannarini, Hendrik Isbarn, Piet Ost, Prasanna Sooriakumaran, Christian I. Surcel, Roderick C N van den Bergh, Inge M. van Oort, Ofer Yossepowitch, Guillaume Ploussard

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine the oncologic benefit or otherwise of local treatment of the prostate in patients with primary metastatic prostate cancer. Methods: A review of the literature was performed in April 2014 using the Medline/PubMed database. Studies were identified using the search terms “prostate cancer,” “metastatic,” “metastasis,” “high risk,” “radiation therapy,” “radiotherapy” and “prostatectomy” from 1990 until April, 2014. Articles were also identified through searches of references of these articles. Results: Retrospective series and population-based data suggest that the use of local treatment of the prostate in patients with primary metastatic prostate cancer may improve cancer-specific survival and overall survival compared with treating these patients with androgen deprivation therapy alone. The clinical outcome in metastatic prostate cancer is largely determined by the extent of lymph node involvement and overall metastatic burden. Contemporary data are lacking to recommend one alternative of local therapy (radiotherapy or radical prostatectomy) over the other. The primary limitation of this literature review is the lack of published randomized trial assessing the role of local treatment in addition to systemic therapy. Conclusions: Local treatment appears to improve oncologic outcomes in metastatic prostate cancer patients. Nevertheless, due to the lack of high-quality evidence, its role needs to be confirmed in future prospective trials. The selection of ideal candidates and optimal treatment alternative (radiotherapy, radical prostatectomy or other) warrants further investigation.

Original languageEnglish
Pages (from-to)755-761
Number of pages7
JournalWorld Journal of Urology
Volume33
Issue number6
DOIs
Publication statusPublished - Jul 5 2014

Keywords

  • High risk
  • Local treatment
  • Metastasis
  • Metastatic
  • Outcomes
  • Prostate cancer
  • Radiation therapy
  • Radical prostatectomy
  • Radiotherapy

ASJC Scopus subject areas

  • Urology

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