Ham Won Sik, Park Jee Soo, Jang Won Sik, Kim Jongchan
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Urology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Republic of Korea.
Front Oncol. 2024 Mar 13;14:1368926. doi: 10.3389/fonc.2024.1368926. eCollection 2024.
We compared radical prostatectomy (RP) and radiotherapy (RT) as local therapies for primary tumors and examined their associations with survival outcomes and urinary tract complications in patients with oligometastatic prostate cancer (omPC).
We evaluated the data of 85 patients diagnosed with omPC who underwent local therapy for primary tumors between January 2008 and December 2018. Of the 85 patients, 31 underwent prostate RT, while 54 underwent RP. Oligometastatic disease was defined as the presence of fewer than five metastatic lesions without visceral metastasis. Urinary tract complications, progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) were evaluated using the Kaplan-Meier method and Cox regression analyses.
Patients treated with RT showed higher prostate-specific antigen levels. There was no significant difference in the 5-year PFS (52.5% vs. 37.9%, p=0.351), CSS (67.6% vs. 84.7%, p=0.473), or OS (63.6% vs. 73.8%, p=0.897) between the RT and RP groups. In the multivariate analyses, the type of local therapy was not associated with PFS (hazard ratio [HR]=1.334, p=0.356), CSS (HR=0.744, p=0.475), or OS (HR=0.953, p=0.897).
Therefore, RP seems to be a possible treatment option for patients with omPC, exhibiting oncologic outcomes comparable to those with RT.
我们比较了根治性前列腺切除术（RP）和放射治疗（RT）作为原发性肿瘤的局部治疗方法，并研究了它们与寡转移性前列腺癌（omPC）患者生存结局和泌尿系统并发症的关联。
我们评估了2008年1月至2018年12月期间85例被诊断为omPC并接受原发性肿瘤局部治疗的患者的数据。在这85例患者中，31例接受了前列腺RT，而54例接受了RP。寡转移性疾病定义为存在少于五个无内脏转移的转移病灶。使用Kaplan-Meier方法和Cox回归分析评估泌尿系统并发症、无进展生存期（PFS）、癌症特异性生存期（CSS）和总生存期（OS）。
接受RT治疗的患者前列腺特异性抗原水平较高。RT组和RP组之间的5年PFS（52.5%对37.9%，p=0.351）、CSS（67.6%对84.7%，p=0.473）或OS（63.6%对73.8%，p=0.897）无显著差异。在多变量分析中，局部治疗类型与PFS（风险比[HR]=1.334，p=0.356）、CSS（HR=0.744，p=0.475）或OS（HR=0.953，p=0.897）无关。
因此，RP似乎是omPC患者的一种可能治疗选择，其肿瘤学结局与RT相当。
