Current concepts in oligometastatic prostate cancer: Is there a role for radical prostatectomy?

INTRODUCTION

Prostate cancer is the most common solid organ malignancy in men. Despite the implementation of PSA screening, the incidence of metastatic prostate cancer in Spain is still around 4%. In this clinical scenario, systemic treatment is the gold standard. Cytoreductive surgery is a standard approach for some solid organ metastatic tumours. Recently there isinterest in exploring the clinical benefit of local treatment (LT) to the primary site in oligometastatic prostate cancer.

MATERIALS AND METHODS

Review of the relevant literature to evaluate the benefit of local treatment (LT) in metastatic prostate cancer.

RESULTS

Local treatment of the primary tumour has demonstrated oncological and symptomatic benefit in other malignancies. Multimodal therapies have demonstrated oncological and symptomatic benefit in locally advanced prostate cancer. Furthermore, surgery has been shown to reduce symptomatic progression in metastatic prostate cancer.

CONCLUSION

The role of surgery to the primary site or metastasis directed treatment is currently being investigated, in the context of oligometastatic prostate cancer. Retrospective data provide a rationale for ongoing randomized controlled trials in this area. New imaging modalities might have a great impact in this conceptual change. Further data is still needed to recommend this approach as a standard of care.