The current role of precision surgery in oligometastatic prostate cancer

ESMO Open

article

M. von Deimling¹  P. Rajwa¹  D. Tilki²  A. Heidenreich¹  M. Pallauf¹  A. Bianchi¹  T. Yanagisawa¹  T. Kawada¹  P.I. Karakiewicz^1,10  P. Gontero^1,11  B. Pradere¹  G. Ploussard^1,12  M. Rink²  S.F. Shariat¹ 

[1]Department of Urology, Comprehensive Cancer Center, Medical University of Vienna

[2]Department of Urology, University Medical Center Hamburg-Eppendorf

[3]Department of Urology, Medical University of Silesia

[4]Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf

[5]Department of Urology, University Hospital Cologne

[6]Department of Urology, University Hospital Salzburg, Paracelsus Medical University Salzburg

[7]Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata

[8]Department of Urology, The Jikei University School of Medicine

[9]Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

[10]Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center

[11]Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino

[12]Department of Urology, La Croix Du Sud Hospital

[13]Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University

[14]Karl Landsteiner Institute of Urology and Andrology

[15]Department of Urology, Weill Cornell Medical College

[16]Department of Urology, University of Texas Southwestern

[17]Department of Urology, Second Faculty of Medicine, Charles University

[18]Institute for Urology and Reproductive Health, Sechenov University

关键词: prostate neoplasms;    oligometastatic;    oligometastasis;    cytoreductive radical prostatectomy;    metastasis-directed therapy;    PSMA-PET;   

DOI  :  10.1016/j.esmoop.2022.100597

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Oligometastatic prostate cancer (omPCa) is a novel intermediate disease state characterized by a limited volume of metastatic cells and specific locations. Accurate staging is paramount to unmask oligometastatic disease, as provided by prostate-specific membrane antigen-positron emission tomography. Driven by the results of prospective trials employing conventional and/or modern staging modalities, the treatment landscape of omPCa has rapidly evolved over the last years. Several treatment-related questions comprising the concept of precision strikes are under development. For example, beyond systemic therapy, cohort studies have found that cytoreductive radical prostatectomy (CRP) can confer a survival benefit in select patients with omPCa. More importantly, CRP has been consistently shown to improve long-term local symptoms when the tumor progresses across disease states due to resistance to systemic therapies. Metastasis-directed treatments have also emerged as a promising treatment option due to the visibility of oligometastatic disease and new technologies as well as treatment strategies to target the novel PCa colonies. Whether metastases are present at primary cancer diagnosis or detected upon biochemical recurrence after treatment with curative intent, targeted yet decisive elimination of disseminated tumor cell hotspots is thought to improve survival outcomes. One such strategy is salvage lymph node dissection in oligorecurrent PCa which can alter the natural history of progressive PCa. In this review, we will highlight how refinements in modern staging modalities change the classification and treatment of (oligo-)metastatic PCa. Further, we will also discuss the current role and future directions of precision surgery in omPCa.

【 授权许可】

CC BY|CC BY-NC-ND