[Treatment concepts for primary oligometastatic prostate cancer].
Therapiekonzepte beim primär oligometastasierten Prostatakarzinom.
Androgen deprivation
External beam radiation
Neoplasm metastasis
Prostate specific antigen
Radical prostatectomy
Journal
Der Urologe. Ausg. A
ISSN: 1433-0563
Titre abrégé: Urologe A
Pays: Germany
ID NLM: 1304110
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
pubmed:
11
4
2020
medline:
2
7
2020
entrez:
11
4
2020
Statut:
ppublish
Résumé
About 5% of prostate cancer patients have distant metastases at diagnosis. In these metastatic hormone-sensitive prostate cancers (mHSPC), systemic therapy is recommended, according to the guidelines. Moreover, metastasis-directed therapy (MDT) is discussed to prolong survival. The contemporary literature concerning local therapy and MDT in patients with mHSPC is summarized. Selective literature search. In 2018, randomized controlled data on local therapy in mHSPC patients were published by the authors of the STAMPEDE study. Here, patients were randomized between standard of care (SOC) ± radiotherapy to the prostate (RT). Within the overall cohort, no difference regarding 3‑year overall survival (OS) was observed. Within a prespecified subgroup of patients with low metastatic burden. Similar results were observed in numerous retrospective studies analyzing radical prostatectomy; prospective randomized studies are pending. For MDT, there are no sufficient data in mHSPC patients yet. In the current guidelines, systematic therapy is standard of care in mHSPC patients. In patients with low metastatic burden, a survival benefit was observed when adding percutaneous RT to the prostate. Retrospective studies also suggest a benefit when adding RP. However, whether MDT prolongs survival is still unknown.
Sections du résumé
BACKGROUND
BACKGROUND
About 5% of prostate cancer patients have distant metastases at diagnosis. In these metastatic hormone-sensitive prostate cancers (mHSPC), systemic therapy is recommended, according to the guidelines. Moreover, metastasis-directed therapy (MDT) is discussed to prolong survival.
OBJECTIVES
OBJECTIVE
The contemporary literature concerning local therapy and MDT in patients with mHSPC is summarized.
METHODS
METHODS
Selective literature search.
RESULTS
RESULTS
In 2018, randomized controlled data on local therapy in mHSPC patients were published by the authors of the STAMPEDE study. Here, patients were randomized between standard of care (SOC) ± radiotherapy to the prostate (RT). Within the overall cohort, no difference regarding 3‑year overall survival (OS) was observed. Within a prespecified subgroup of patients with low metastatic burden. Similar results were observed in numerous retrospective studies analyzing radical prostatectomy; prospective randomized studies are pending. For MDT, there are no sufficient data in mHSPC patients yet.
CONCLUSIONS
CONCLUSIONS
In the current guidelines, systematic therapy is standard of care in mHSPC patients. In patients with low metastatic burden, a survival benefit was observed when adding percutaneous RT to the prostate. Retrospective studies also suggest a benefit when adding RP. However, whether MDT prolongs survival is still unknown.
Identifiants
pubmed: 32274541
doi: 10.1007/s00120-020-01186-w
pii: 10.1007/s00120-020-01186-w
doi:
Substances chimiques
Androgen Antagonists
0
Antineoplastic Agents, Hormonal
0
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM