MP24-10 NEWLY-DIAGNOSED LOW-VOLUME METASTATIC PROSTATE CANCER; IS THERE A PLACE FOR CYTOREDUCTIVE RADICAL PROSTATECTOMY?

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) II (MP24)1 Sep 2021MP24-10 NEWLY-DIAGNOSED LOW-VOLUME METASTATIC PROSTATE CANCER; IS THERE A PLACE FOR CYTOREDUCTIVE RADICAL PROSTATECTOMY? Elise De Bleser, Nicolaas Lumen, Sarah Buelens, Wesley Verla, Wietse Claeys, Valérie Fonteyne, Sofie Verbeke, Geert Villeirs, Kathia De Man, Sylvie Rottey, Charles Van Praet, Karel Decaestecker, and Piet Ost Elise De BleserElise De Bleser More articles by this author , Nicolaas LumenNicolaas Lumen More articles by this author , Sarah BuelensSarah Buelens More articles by this author , Wesley VerlaWesley Verla More articles by this author , Wietse ClaeysWietse Claeys More articles by this author , Valérie FonteyneValérie Fonteyne More articles by this author , Sofie VerbekeSofie Verbeke More articles by this author , Geert VilleirsGeert Villeirs More articles by this author , Kathia De ManKathia De Man More articles by this author , Sylvie RotteySylvie Rottey More articles by this author , Charles Van PraetCharles Van Praet More articles by this author , Karel DecaesteckerKarel Decaestecker More articles by this author , and Piet OstPiet Ost More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002015.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radiotherapy to the prostate (RTp) has recently been shown to prolong survival in patients with low-volume newly-diagnosed metastatic prostate cancer (ndmPC). Therefore it was suggested to be a possible standard of care treatment strategy in these patients. In contrast, to date, there is no data available whether cytoreductive radical prostatectomy (cRP) is equally beneficial as RTp for these patients. The objective was to evaluate the efficacy and safety of cRP in low-volume ndmPC. METHODS: Eligible patients had low-volume ndmPC and were included in this prospective, multicentric study. Patients were included from 2014 until the end of 2020. In total, 109 patients entered the study and were offered cRP, RTp or no local therapy (NLT) (48, 26, 35, respectively). Treatment allocation was dependent on patient's preference. Median follow-up was 32 months (IQR: 16-49). The aim was to compare the outcome of cRP to RTp and NLT. Kaplan-Meier statistics were used to assess overall survival (OS), cancer-specific survival (CSS) and local-event free survival (LEFS). Uni- and multivariate Cox regression analysis was used to identify prognostic factors influencing OS. RESULTS: 3y-OS was 87%, 100% and 69% and 3y-CSS was 87%, 100% and 75% for cRP, RTp and NLT, respectively. OS was better for cRP and RTp compared to NLT (p=0.007 and p=0.04, respectively). However, no difference in OS was observed between cRP and RTp (0.9) (Figure 1). The 3y-LEFS was 86%, 70% and 55% for cRP, RT and NLT, respectively. Following cRP, LEFS was better compared to RTp (p=0.02) and NLT (p=0.004). No significant difference was seen between RTp and NLT (p=0.5). Negative prognostic factors for OS were advanced tumor stage, Eastern Cooperative Oncology Group ≥2 and NLT.Important selection bias was present as a consequence of treatment allocation being dependent on patient’s preference. CONCLUSIONS: OS and CSS of cRP was similar to RTp and was better compared to NLT and is an effective treatment strategy to prevent local events. Source of Funding: Kom Op Tegen Kanker (Stand Up to Cancer), Belgium © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e415-e416 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elise De Bleser More articles by this author Nicolaas Lumen More articles by this author Sarah Buelens More articles by this author Wesley Verla More articles by this author Wietse Claeys More articles by this author Valérie Fonteyne More articles by this author Sofie Verbeke More articles by this author Geert Villeirs More articles by this author Kathia De Man More articles by this author Sylvie Rottey More articles by this author Charles Van Praet More articles by this author Karel Decaestecker More articles by this author Piet Ost More articles by this author Expand All Advertisement Loading ...