Mistretta Francesco A, Luzzago Stefano, Conti Andrea, Verri Elena, Marvaso Giulia, Collà Ruvolo Claudia, Catellani Michele, Di Trapani Ettore, Cozzi Gabriele, Bianchi Roberto, Ferro Matteo, Cordima Giovanni, Brescia Antonio, Cossu Rocca Maria, Mirone Vincenzo, Jereczek-Fossa Barbara A, Nolè Franco, de Cobelli Ottavio, Musi Gennaro
Department of Urology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy.
Cancers (Basel). 2022 May 6;14(9):2313. doi: 10.3390/cancers14092313.
Background: We compared multimodality treatment (MMT, defined as robot-assisted radical prostatectomy (RARP) with androgen deprivation therapy (ADT), with or without adjuvant radiotherapy (RT)) vs. ADT alone in oligometastatic prostate cancer (OPC) patients. Methods: From 2010 to 2018, we identified 74 patients affected by cM1a-b OPC (≤5 metastases). Kaplan−Meier (KM) plots depicted cancer-specific mortality (CSM), disease progression, metastatic castration-resistant PC (mCRPC), and time to second-line systemic therapy rates. Multivariable Cox regression models (MCRMs) focused on disease progression and mCRPC. Results: Forty (54.0%) MMT and thirty-four (46.0%) ADT patients were identified. On KM plots, higher CSM (5.9 vs. 37.1%; p = 0.02), mCRPC (24.0 vs. 62.5%; p < 0.01), and second-line systemic therapy (33.3 vs. 62.5%; p < 0.01) rates were recorded in the ADT group. No statistically significant difference was recorded for disease progression. ForMCRMs adjusted for the metastatic site and PSA, a higher mCRPC rate was recorded in the ADT group. No statistically significant difference was recorded for disease progression. Treatment-related adverse events occurred in 5 (12.5%) MMT vs. 15 (44.1%) ADT patients (p < 0.01). Conclusions: MMT was associated with lower CSM, mCRPC, and second-line therapy rates. A lower rate of treatment-related adverse events was recorded for the MMT group.
我们比较了多模式治疗（MMT，定义为机器人辅助根治性前列腺切除术（RARP）联合雄激素剥夺治疗（ADT），联合或不联合辅助放疗（RT））与单纯ADT在寡转移性前列腺癌（OPC）患者中的疗效。方法：2010年至2018年，我们纳入了74例cM1a - b期OPC（转移灶≤5个）患者。Kaplan - Meier（KM）曲线描述了癌症特异性死亡率（CSM）、疾病进展、转移性去势抵抗性前列腺癌（mCRPC）以及二线全身治疗率。多变量Cox回归模型（MCRMs）重点关注疾病进展和mCRPC。结果：确定了40例（54.0%）接受MMT治疗的患者和34例（46.0%）接受ADT治疗的患者。在KM曲线上，ADT组的CSM（5.9%对37.1%；p = 0.02）、mCRPC（24.0%对62.5%；p < 0.01）和二线全身治疗（33.3%对62.5%；p < 0.01）率更高。疾病进展方面未记录到统计学显著差异。对于根据转移部位和前列腺特异性抗原（PSA）调整的MCRMs，ADT组的mCRPC率更高。疾病进展方面未记录到统计学显著差异。5例（12.5%）接受MMT治疗的患者和15例（44.1%）接受ADT治疗的患者发生了治疗相关不良事件（p < 0.01）。结论：MMT与较低的CSM、mCRPC和二线治疗率相关。MMT组记录到的治疗相关不良事件发生率较低。
