Cytoreductive surgery for men with metastatic prostate cancer.

Abstract

Background. Cytoreductive surgery for metastatic prostate cancer is an emerging area of interest with a potential upside that includes local control, delayed initiation of hormone therapy, and possibly improved cancer specific survival. In order for radical prostatectomy to be an effective treatment option for men in this group, the benefits must outweigh the surgical morbidity. The aim of this study was to present a case series and assess the literature feasibility of cytoreductive surgery for men with metastatic prostate cancer. Methods. The case series (n = 6) evaluated each patient with regard to preoperative prostate-specific antigen, grade, stage, adjuvant therapy, and surgical outcomes. A full literature review of cytoreductive radical prostatectomy was undertaken. Results. A surgical approach had demonstrated benefit without deleterious effect in these case. Notably, in the three men on ADT pre-operatively, the PSA remained lower after aggressive treatment of local and metastatic disease, and at follow-up, none of the men had local symptoms from malignancy or the surgery. Conclusions. This case series supports recent data demonstrating that radical prostatectomy for carefully selected men is feasible. There is a need for further studies to explore the role of cytoreductive surgery in men with oligometastatic prostate cancer.