Radical prostatectomy in metastatic prostate cancer: a systematic review
Abstract
Objectives: To review the existing English language literature on the role of local treatment (LT) in metastatic prostate cancer patient (mPCa), with specific focus on radical prostatectomy (RP), in regard to its safety and effect on survival.
Methods: A review of the literature was performed using PubMed, Medline, and Cochrane databases focusing on all articles addressing RP in mPCa. Electronic articles published ahead of print were also considered. Search was limited to the English language and relied on keywords: prostatectomy and metastatic prostate cancer. Studies were selected according to sample size, contemporaneity, and clinical relevance of the results.
Results: The safety of RP in mPCa was confirmed in three studies. The impact of RP in mPCa on overall mortality (OM) and/or cancer-specific mortality (CSM) was examined in seven retrospective population-based studies. All showed survival benefit in patients treated with RP relative to no local treatment (NLT) and/or radiation therapy (RT).
Conclusions: Contemporary literature, that is exclusively based on retrospective data, suggests the safety and efficacy of RP in mPCa patients. RP may improve survival relative to NLT or RT. However, all studies were retrospective. Thus, information form ongoing prospective randomized trials will be essential prior to use of RP in metastatic setting, in routine clinical practice.
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DOI: http://dx.doi.org/10.18103/imr.v3i6.482
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