Cytoreductive surgery for men with metastatic prostate cancer.
BACKGROUND
Cytoreductive surgery for metastatic prostate cancer is an emerging area of interest with a potential upside that includes local control, delayed initiation of hormone therapy, and possibly improved cancer specific survival. In order for radical prostatectomy to be an effective treatment option for men in this group, the benefits must outweigh the surgical morbidity. The aim of this study was to present a case series and assess the literature feasibility of cytoreductive surgery for men with metastatic prostate cancer.


METHODS
A retrospective review of clinical notes was performed to identify men with metastatic prostate cancer who underwent cytoreductive surgery between 2012 and 2014 for a group of urologists at a single institution in Melbourne. Each patient was evaluated with regard to preoperative prostate-specific antigen, grade, stage, adjuvant therapy, and surgical outcomes.


RESULTS
Six cases were identified. This included 1 pelvic exenteration and 5 robot-assisted radical prostatectomies. The men who underwent RARP had uncomplicated recoveries, regained continence within 3 months and remained pad-free at follow up. All patients proceeded to additional treatment of sites of metastatic disease with a variable PSA response, however, 3 of 6 men required recommencement of ADT for biochemical progression at follow up.


CONCLUSIONS
This data supports recent findings demonstrating that radical prostatectomy for metastatic prostate cancer is feasible. Further studies are needed to explore the role of cytoreductive surgery with regards to the potential oncological benefit.
University of Melbourne, Department of Surgery, Austin Hospital, Melbourne, Australia.
Nikolas
N
Katelaris
University of Melbourne, Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Epworth Healthcare, Melbourne, Australia.
Declan
D
Murphy
University of Melbourne, Department of Surgery, Austin Hospital, Melbourne, Australia; University of Melbourne, Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Epworth Healthcare, Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Australia.
Nathan
N
Lawrentschuk
St. Georges, University of London, London, United Kingdom.
Athos
A
Katelaris
University of Melbourne, Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Epworth Healthcare, Melbourne, Australia.
Daniel
D
Moon
Cytoreduction; Metastasis; Prostatectomy; Prostatic neoplasms
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