SIU 2017: Observation of Preliminary Clinical Effect and Analysis of Perioperative Complications of Radical Prostatectomy for Patients with Oligo-Metastatic Prostate Cancer

Lisbon, Portugal ( Radical prostatectomy in the setting of metastatic prostate cancer is gaining more attention in the recent past based4. on retrospective series, small institutional series and population level analysis demonstrating modest benefit – typically in delay to systemic therapy and improved local control. While there are ongoing large multinational clinical trials to answer this question, the data will take many years to acquire.

In this study, the authors add to the literature with their single institution series of RP in patients with oligometastatic prostate cancer. Their primary focus was assessing short term perioperative outcomes and ensuring safety. To that effect, they enrolled 247 patients over a 1 year period – 25 of whom had oligometastatic disease, and 222 had localized PCa.

• It is unclear if patients with oligometastatic disease were identified pre-operatively or found to have nodal disease on final pathology

In terms of outcomes, they found that 21 patients (84%) had PSA decline in the oligometastatic group; expectedly lower than in the localized group (95.5%). Of the 25 cases with oligometastatic disease, there were 6 cases of postoperative complications (24%), including one Grade III-IV complication (4.0%). This was no different than the rates in the localized group.

Based on this, they conclude that RP in setting of oligometastatic disease is safe and comparable to RP for localized PCa. While this is intuitive and confirms findings in other series, we caution the authors on ensuring better rigor for their study. Further details regarding the selection criteria and pre-operative staging are needed.

Speaker(s): Yunjie Yang, China

Institution(s): Fudan University, Shanghai Cancer Center, China

Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, twitter: @tchandra_uromd, at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal