Department of urology, CHU Souss Massa, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco.
Casablanca Urology Center, Casablanca, Morocco.
Prostate Cancer Prostatic Dis. 2024 Dec;27(4):645-653. doi: 10.1038/s41391-023-00752-5. Epub 2023 Nov 20.
There is a growing interest about the role of radical prostatectomy (RP) in local cancer control in oligometastatic prostate cancer (PCa).
To evaluate the oncological and functional outcomes of RP in the management of oligometastatic PCa through a systematic review.
A systematic review search was performed and the following bibliographic databases were accessed: PubMed, Scopus, Embase and the Cochrane central register of controlled trials were searched from January 2000 to November 2022. This was carried out by the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines.
Based on the literature search of 384 articles, 11 (511 patients) met the inclusion criteria (mean age: 65.5 yr.). Positive surgical margins were 59%. Median follow-up ranged from 13 to 64 months. Clinical progression-free survival ranged from 56% at 3 years to 45% at 7 years. Specific and overall survival rates ranged from 60 to 80.5% and 78 to 80% at 5 years, respectively. Clavien ≥3 complications ranged from 0 to 21%. The urinary incontinence rate was 14.5%.
Similar to published studies, RP of oligometastatic PCa appears to be safe with acceptable morbidity in selected patients. The lack of a consensual definition, the low level of evidence and the bias of the comparative and retrospective studies available do not allow practical recommendations to be made. There is currently no place for metastatic surgery outside of participation in a clinical trial.
在寡转移前列腺癌中，根治性前列腺切除术（RP）在局部癌症控制中的作用引起了越来越多的关注。
通过系统评价评估 RP 在寡转移前列腺癌治疗中的肿瘤学和功能结果。
系统检索并查阅了以下文献数据库：PubMed、Scopus、Embase 和 Cochrane 对照试验中心注册库，检索时间为 2000 年 1 月至 2022 年 11 月。这是按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的。
根据对 384 篇文章的文献搜索，11 篇（511 例患者）符合纳入标准（平均年龄：65.5 岁）。切缘阳性率为 59%。中位随访时间从 13 个月到 64 个月不等。临床无进展生存率从 3 年时的 56%到 7 年时的 45%不等。特异性和总生存率分别在 5 年时为 60%到 80.5%和 78%到 80%。Clavien≥3 级并发症发生率从 0 到 21%不等。尿失禁发生率为 14.5%。
与已发表的研究相似，RP 治疗寡转移前列腺癌在选择的患者中似乎是安全的，且发病率可接受。缺乏共识定义、现有比较和回顾性研究的证据水平低以及存在偏倚，使得无法提出实际建议。转移性手术目前除了参与临床试验外，没有其他作用。
