CLINICAL OUTCOMES OF CYTOREDUCTIVE PROSTATECTOMY IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER

Abstract

(Introduction) In this study, we investigated the surgical outcomes and cancer control achieved with cytoreductive radical prostatectomy (cRP) in patients with castration-resistant prostate cancer (CRPC). (Patients and Methods) The study included 12 patients who underwent cRP at Kure Medical Center between August 2010 and April 2022 for diagnosis of CRPC. Perioperative outcomes, decline in serum prostate-specific antigen (PSA) levels from baseline, PSA progression-free survival, and postoperative treatment-free survival were recorded. (Results) We observed that 5 of 12 patients showed no metastases at the time of initial diagnosis, 2 had only regional lymph node metastases, and 5 had distant metastases. No patient showed identifiable metastases on imaging studies at the time of surgery. The median PSA value at the time of surgery was 0.47 ng/mL, and 5 patients had PSA values ≥1 ng/mL. All patients underwent laparoscopic cRP. Postoperative adverse events included Clavien-Dindo grade I complications in 4 and grade III complications in 1 patient; however, no patient developed rectal injury. Postoperative serum PSA levels were < 0.2 ng/mL in 8 of 12 patients (66.7%) and undetectable in 5 patients (41.7%). The median postoperative PSA progression-free survival and postoperative treatment-free survival were 12.4 and 14.5 months, respectively. (Conclusion) cRP was associated with a good anti-cancer effect in selected cases of CRPC and may serve as a potentially useful treatment option in this patient population.