The mainstay of treatment for men with three or fewer non-castrate metastatic lesions outside of the prostate remains morbid palliative androgen deprivation therapy. We believe there is now a significant body of retrospective literature to suggest a survival benefit if these men have radical treatment to their primary tumour alongside 'metastasis-directed therapy' to the metastatic deposits. However, this regimen should be reserved to high-volume centres with quality assurance programmes and excellent outcomes. Patients should be made clear as to the uncertainty of benefit for this multi-site treatment strategy, and we await the publication of randomised controlled trials reporting in the next 5 years.
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Current treatment options in oncology. 2016 Dec [Epub]
Daniel J Stevens, Prasanna Sooriakumaran
Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Room 6607, Level 6, Headington, Oxford, OX3 9DU, UK., Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Room 6607, Level 6, Headington, Oxford, OX3 9DU, UK. .