A systematic review of cytoreductive prostatectomy outcomes and complications in oligometastatic disease

作     者：Andrey Morozov Leonid Chuvalov Mark Taratkin Mikhail Enikeev Leonid Rapoport Nirmish Singla Eric Barret Elena Poddubskaya Maria Borodina Georg Salomon Juan Gomez Rivas Dmitry Enikeev 

作者机构：Institute for Urology and Reproductive HealthSechenov UniversityMoscowRussia Young Academic UrologistsEAUthe Netherlands Department of UrologyJames Buchanan Brady Urological InstituteThe Johns Hopkins University School of MedicineBaltimoreUSA Department of UrologyInstitut Mutualiste MontsourisParisFrance Sechenov UniversityMoscowRussia Hertsen Moscow Oncology Research InstituteMoscowRussia Hertsen Moscow Oncology Research InstituteMoscowRussia Martini ClinicUniversity Medical Center Hamburg-EppendorfHamburgGermany Department of UrologyClinico San Carlos University HospitalMadridSpain Department of UrologyMedical University of ViennaViennaAustria 

出 版 物：《Asian Journal of Urology》 (亚洲泌尿外科杂志（英文）)

年 卷 期：2024年第11卷第2期

页      面：208-220页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Systematicreview Prostatecancer Oligometastatic Bone metastases Cytoreductive prostatectomy 

摘      要：Objective: To analyze outcomes and complications of cytoreductive prostatectomy (CRP) for oligometastatic prostate cancer (PCa) in order to elucidate its role in this ***: We performed a systematic literature search using three databases (Medline, Scopus, and Web of Science). The primary endpoints were oncologic outcomes. The secondary endpoints were complication rates and functional ***: In all studies, overall survival was better or at least comparable variable in the groups with CRP compared to no local treatment. The greatest benefit from CRP in 5-year overall survival in one study was 67.4% for CRP versus 22.5% for no local treatment. Cancer-specific survival (CSS) showed the same trend. Several authors found significant benefits from CSS in the CRP group: from 79% vs. 46% to 100% vs. 61%. CRP was a predictor of better CSS (hazard ratio 0.264, p=0.004). Positive surgical margin rates differed widely from 28.6% to 100.0%. Urinary continence in CRP versus RP for localized PCa was significantly lower (57.4% vs. 90.8%, p0.0001). Severe incontinence occurred seldom (2.5%-18.6%). Total complication rates after CRP differed widely, from 7.0% to 43.6%. Rates of grades 1 and 2 events prevailed. Patients on ADT alone also showed a considerable number of complications varying from 5.9% to 57.7%.Conclusion: CRP improves medium-term cancer control in patients with oligometastatic PCa. The morbidity and complication rates of this surgery are comparable with other approaches, but postoperative incontinence rate is higher compared with RP for localized disease.