Metastatic hormone sensitive prostate cancer: local treatment strategies.
Prostate cancer; metastatic; local treatment
Prostatectomy
Radiotherapy
Standard of care; survival
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
24
10
2019
accepted:
03
06
2020
pubmed:
27
6
2020
medline:
23
7
2021
entrez:
27
6
2020
Statut:
ppublish
Résumé
The landscape of the management of metastatic prostate cancer is changing rapidly and there is growing interest in the local treatment of the primary in these patients. The effect of local treatment on the outcome of metastatic prostate cancer patients was addressed based on retrospective analysis but now also based on prospective randomized trials. This article provides an overview of the currently available literature in this field. A literature review was done searching the Medline database for English language articles using the keywords "metastatic prostate cancer", and "local treatment", "radiotherapy", "prostatectomy". The data of prospective randomized studies and the data of case-control studies or retrospective analysis were summarized in a narrative fashion. Data from two prospective randomized trials exploring the effect of local treatment of the prostate in hormone-sensitive metastatic prostate cancer showed no improvement of overall survival in the individual overall cohorts as well as in the pooled analysis (HR 0.92, 95% CI 0.81-1.04). There was an improvement of failure-free survival (pooled analysis HR 0.76, 95% CI 0.69-0.0.84). There was also an improved overall survival associated with radiotherapy in patients with < 5 metastases and with low volume disease. Data from prospective non-randomized or retrospective studies are inconclusive and underlies major selection biases. Based on prospective randomized trials, local treatment by radiotherapy does not improve the overall survival in unselected metastatic prostate cancer patients. An effect can be seen in low volume patients or patients with < 5 metastases.
Identifiants
pubmed: 32588203
doi: 10.1007/s00345-020-03296-8
pii: 10.1007/s00345-020-03296-8
doi:
Substances chimiques
Antineoplastic Agents, Hormonal
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
327-337Commentaires et corrections
Type : CommentIn
Références
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