Does Cytoreductive Prostatectomy Really Have an Impact on Prognosis in Prostate Cancer Patients with Low-volume Bone Metastasis?
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Does Cytoreductive Prostatectomy Really Have an Impact on Prognosis in Prostate Cancer Patients with Low-volume Bone Metastasis? Results from a Prospective Case-Control Study. / Steuber, Thomas; Berg, Kasper D; Røder, Martin A; Brasso, Klaus; Iversen, Peter; Huland, Hartwig; Tiebel, Anne; Schlomm, Thorsten; Haese, Alexander; Salomon, Georg; Budäus, Lars; Tilki, Derya; Heinzer, Hans; Graefen, Markus; Mandel, Philipp.
in: EUR UROL FOCUS, Jahrgang 3, Nr. 6, 12.2017, S. 646-649.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Does Cytoreductive Prostatectomy Really Have an Impact on Prognosis in Prostate Cancer Patients with Low-volume Bone Metastasis?
T2 - Results from a Prospective Case-Control Study
AU - Steuber, Thomas
AU - Berg, Kasper D
AU - Røder, Martin A
AU - Brasso, Klaus
AU - Iversen, Peter
AU - Huland, Hartwig
AU - Tiebel, Anne
AU - Schlomm, Thorsten
AU - Haese, Alexander
AU - Salomon, Georg
AU - Budäus, Lars
AU - Tilki, Derya
AU - Heinzer, Hans
AU - Graefen, Markus
AU - Mandel, Philipp
N1 - Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - The impact of cytoreductive radical prostatectomy (CRP) on oncological outcomes in patients with prostate cancer (PCa) and distant metastases has been demonstrated by retrospective data with their potential selection bias. Using prospective institutional data, we compared the outcomes between 43 PCa patients with low-volume bone metastases (1-3 lesions) undergoing CRP (median follow-up 32.7 mo) and 40 patients receiving best systemic therapy (BST; median follow-up 82.2 mo). The inclusion criteria for both cohorts were identical. So far, no significant difference in castration resistant-free survival (p=0.92) or overall survival (p=0.25) has been detected. Compared to recent reports, the outcomes for our control group are more favorable, indicating a potential selection bias in the previous retrospective studies. Therefore, the unclear oncological effect has to be weighed against the potential risks of CRP. However, patients benefit from a significant reduction in locoregional complications (7.0% vs 35%; p<0.01) when undergoing CRP.PATIENT SUMMARY: In this study we analyzed the impact of surgery in patients with prostate cancer and bone metastases. Using prospective data, we could not show a significant benefit of surgery on survival, but the rate of locoregional complications was lower. Therefore, patients should be treated within prospective trials evaluating the role of cytoreductive prostatectomy in low-volume, bone metastatic prostate cancer.
AB - The impact of cytoreductive radical prostatectomy (CRP) on oncological outcomes in patients with prostate cancer (PCa) and distant metastases has been demonstrated by retrospective data with their potential selection bias. Using prospective institutional data, we compared the outcomes between 43 PCa patients with low-volume bone metastases (1-3 lesions) undergoing CRP (median follow-up 32.7 mo) and 40 patients receiving best systemic therapy (BST; median follow-up 82.2 mo). The inclusion criteria for both cohorts were identical. So far, no significant difference in castration resistant-free survival (p=0.92) or overall survival (p=0.25) has been detected. Compared to recent reports, the outcomes for our control group are more favorable, indicating a potential selection bias in the previous retrospective studies. Therefore, the unclear oncological effect has to be weighed against the potential risks of CRP. However, patients benefit from a significant reduction in locoregional complications (7.0% vs 35%; p<0.01) when undergoing CRP.PATIENT SUMMARY: In this study we analyzed the impact of surgery in patients with prostate cancer and bone metastases. Using prospective data, we could not show a significant benefit of surgery on survival, but the rate of locoregional complications was lower. Therefore, patients should be treated within prospective trials evaluating the role of cytoreductive prostatectomy in low-volume, bone metastatic prostate cancer.
KW - Journal Article
U2 - 10.1016/j.euf.2017.06.016
DO - 10.1016/j.euf.2017.06.016
M3 - SCORING: Journal article
C2 - 28753877
VL - 3
SP - 646
EP - 649
JO - EUR UROL FOCUS
JF - EUR UROL FOCUS
SN - 2405-4569
IS - 6
ER -