title: A comprehensive review of contemporary role of local treatment of the primary tumor and/or the metastases in metastatic prostate cancer.
abstract: To provide an overview of the currently available literature regarding local control of primary tumor and oligometastases in metastatic prostate cancer and salvage lymph node dissection of clinical lymph node relapse after curative treatment of prostate cancer. Evidence Acquisition. A systematic literature search was conducted in 2014 to identify abstracts, original articles, review articles, research articles, and editorials relevant to the local control in metastatic prostate cancer. Evidence Synthesis. Local control of primary tumor in metastatic prostate cancer remains experimental with low level of evidence. The concept is supported by a growing body of genetic and molecular research as well as analogy with other cancers. There is only one retrospective observational population based study showing prolonged survival. To eradicate oligometastases, several options exist with excellent local control rates. Stereotactic body radiotherapy is safe, well tolerated, and efficacious treatment for lymph node and bone lesions. Both biochemical and clinical progression are slowed down with a median time to initiate ADT of 2 years. Salvage lymph node dissection is feasible in patients with clinical lymph node relapse after local curable treatment. Conclusion. Despite encouraging oncologic midterm results, a complete cure remains elusive in metastatic prostate cancer patients. Further advances in imaging are crucial in order to rapidly evolve beyond the proof of concept.
authors.affiliation: Department of Urology, Jules Bordet Institute, 1 Héger-Bordet Street, 1000 Brussels, Belgium ; Université Libre de Bruxelles, 50 Franklin Roosevelt Avenue, 1050 Brussels, Belgium.
authors.forename: Fouad
authors.initials: F
authors.lastname: Aoun
authors.affiliation: Department of Urology, Jules Bordet Institute, 1 Héger-Bordet Street, 1000 Brussels, Belgium ; Université Libre de Bruxelles, 50 Franklin Roosevelt Avenue, 1050 Brussels, Belgium.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Peltier
authors.affiliation: Department of Urology, Jules Bordet Institute, 1 Héger-Bordet Street, 1000 Brussels, Belgium ; Université Libre de Bruxelles, 50 Franklin Roosevelt Avenue, 1050 Brussels, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: van Velthoven
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal