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The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry
BACKGROUND: Radiotherapy to the prostate (RTp) prolongs survival for patients with low-volume, newly diagnosed metastatic prostate cancer (ndmPC). OBJECTIVE: to evaluate whether cytoreductive radical prostatectomy (cRP) is equally beneficial as RTp in low-volume ndmPC. DESIGN, SETTING, AND PARTICIPA...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317829/ https://www.ncbi.nlm.nih.gov/pubmed/34337536 http://dx.doi.org/10.1016/j.euros.2021.05.006 |
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author | Lumen, Nicolaas De Bleser, Elise Buelens, Sarah Verla, Wesley Poelaert, Filip Claeys, Wietse Fonteyne, Valérie Verbeke, Sofie Villeirs, Geert De Man, Kathia Rottey, Sylvie Van Praet, Charles Decaestecker, Karel Ost, Piet |
author_facet | Lumen, Nicolaas De Bleser, Elise Buelens, Sarah Verla, Wesley Poelaert, Filip Claeys, Wietse Fonteyne, Valérie Verbeke, Sofie Villeirs, Geert De Man, Kathia Rottey, Sylvie Van Praet, Charles Decaestecker, Karel Ost, Piet |
author_sort | Lumen, Nicolaas |
collection | PubMed |
description | BACKGROUND: Radiotherapy to the prostate (RTp) prolongs survival for patients with low-volume, newly diagnosed metastatic prostate cancer (ndmPC). OBJECTIVE: to evaluate whether cytoreductive radical prostatectomy (cRP) is equally beneficial as RTp in low-volume ndmPC. DESIGN, SETTING, AND PARTICIPANTS: A multicenter prospective registry was established in 2014 to observe patients with ndmPC. Eligible patients were offered cRP or RTp. For this study we selected only patients with low-volume ndmPC (n = 109). Of these, 48, 26, and 35 patients underwent cRP, RTp, and no local therapy (NLT), respectively. Median follow-up was 32 mo (interquartile range 16–49). INTERVENTION: cRP was compared with RTp and NLT. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS), cancer-specific survival (CSS), and local event–free survival (LEFS) were calculated using the Kaplan-Meier method. Factors prognostic for OS were identified using univariate and multivariate Cox regression analysis. RESULTS AND LIMITATIONS: The 2-yr OS was 93%, 100%, and 69%, and 2-yr CSS was 93%, 100%, and 75% for cRP, RTp, and NLT, respectively. The cRP and RTp groups had better OS compared to NLT and there was no significant difference between cRP and RTp. The 2-yr LEFS was 92%, 77%, and 60% for cRP, RTp, and NLT, respectively. The cRP group had better LEFS compared to RTp and NLT, and there was no significant difference between RTp and NLT. Advanced tumor stage, Eastern Cooperative Oncology Group performance status ≥2, and NLT were negative prognostic factors for OS. The main limitation is selection of fitter patients with less advanced tumors for cRP and the small sample size. CONCLUSIONS: For selected patients with low-volume ndmPC, cRP is able to achieve similar OS and CSS to RTp. cRP is effective in preventing local events due to disease progression. PATIENT SUMMARY: Patients with a low volume of newly diagnosed prostate cancer that has spread beyond the prostate gland might benefit from removal of the prostate, which we found was as effective as radiotherapy to the prostate in prolonging survival. Removal of the prostate is effective in preventing urinary problems caused by cancer progression. |
format | Online Article Text |
id | pubmed-8317829 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-83178292021-07-29 The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry Lumen, Nicolaas De Bleser, Elise Buelens, Sarah Verla, Wesley Poelaert, Filip Claeys, Wietse Fonteyne, Valérie Verbeke, Sofie Villeirs, Geert De Man, Kathia Rottey, Sylvie Van Praet, Charles Decaestecker, Karel Ost, Piet Eur Urol Open Sci Prostate Cancer BACKGROUND: Radiotherapy to the prostate (RTp) prolongs survival for patients with low-volume, newly diagnosed metastatic prostate cancer (ndmPC). OBJECTIVE: to evaluate whether cytoreductive radical prostatectomy (cRP) is equally beneficial as RTp in low-volume ndmPC. DESIGN, SETTING, AND PARTICIPANTS: A multicenter prospective registry was established in 2014 to observe patients with ndmPC. Eligible patients were offered cRP or RTp. For this study we selected only patients with low-volume ndmPC (n = 109). Of these, 48, 26, and 35 patients underwent cRP, RTp, and no local therapy (NLT), respectively. Median follow-up was 32 mo (interquartile range 16–49). INTERVENTION: cRP was compared with RTp and NLT. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS), cancer-specific survival (CSS), and local event–free survival (LEFS) were calculated using the Kaplan-Meier method. Factors prognostic for OS were identified using univariate and multivariate Cox regression analysis. RESULTS AND LIMITATIONS: The 2-yr OS was 93%, 100%, and 69%, and 2-yr CSS was 93%, 100%, and 75% for cRP, RTp, and NLT, respectively. The cRP and RTp groups had better OS compared to NLT and there was no significant difference between cRP and RTp. The 2-yr LEFS was 92%, 77%, and 60% for cRP, RTp, and NLT, respectively. The cRP group had better LEFS compared to RTp and NLT, and there was no significant difference between RTp and NLT. Advanced tumor stage, Eastern Cooperative Oncology Group performance status ≥2, and NLT were negative prognostic factors for OS. The main limitation is selection of fitter patients with less advanced tumors for cRP and the small sample size. CONCLUSIONS: For selected patients with low-volume ndmPC, cRP is able to achieve similar OS and CSS to RTp. cRP is effective in preventing local events due to disease progression. PATIENT SUMMARY: Patients with a low volume of newly diagnosed prostate cancer that has spread beyond the prostate gland might benefit from removal of the prostate, which we found was as effective as radiotherapy to the prostate in prolonging survival. Removal of the prostate is effective in preventing urinary problems caused by cancer progression. Elsevier 2021-06-05 /pmc/articles/PMC8317829/ /pubmed/34337536 http://dx.doi.org/10.1016/j.euros.2021.05.006 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Prostate Cancer Lumen, Nicolaas De Bleser, Elise Buelens, Sarah Verla, Wesley Poelaert, Filip Claeys, Wietse Fonteyne, Valérie Verbeke, Sofie Villeirs, Geert De Man, Kathia Rottey, Sylvie Van Praet, Charles Decaestecker, Karel Ost, Piet The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry |
title | The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry |
title_full | The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry |
title_fullStr | The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry |
title_full_unstemmed | The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry |
title_short | The Role of Cytoreductive Radical Prostatectomy in the Treatment of Newly Diagnosed Low-volume Metastatic Prostate Cancer. Results from the Local Treatment of Metastatic Prostate Cancer (LoMP) Registry |
title_sort | role of cytoreductive radical prostatectomy in the treatment of newly diagnosed low-volume metastatic prostate cancer. results from the local treatment of metastatic prostate cancer (lomp) registry |
topic | Prostate Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317829/ https://www.ncbi.nlm.nih.gov/pubmed/34337536 http://dx.doi.org/10.1016/j.euros.2021.05.006 |
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