Cancer medicine · 2026
Oncologic Outcomes of Cytoreductive Radical Prostatectomy in Patients With Synchronous Metastatic Castration-Sensitive Prostate Cancer: A Retrospective Analysis.
СтатьяНазвание и аннотация: Перевод в очереди
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Morozumi Kento, Numahata Kenji, Oikawa Masaaki, Konno Masato, Kusumoto Hiroki, Akito Kuromoto, Katsumata Yuki, Sato Masahiko, Kaiho Yasuhiro
Аннотация
OBJECTIVES: Local therapy for metastatic castration-sensitive prostate cancer (mCSPC) remains controversial. This study aimed to assess the feasibility, safety, and oncologic outcomes of cytoreductive radical prostatectomy (cRP) in patients with synchronous mCSPC, with a particular focus on pathological findings.
METHOD: We retrospectively analyzed 61 patients with mCSPC who underwent cRP following neoadjuvant androgen deprivation therapy (ADT). Clinical, perioperative, and pathological parameters were reviewed. Survival outcomes were assessed in relation to biopsy Gleason grade (GG), metastatic burden, PSA dynamics, and pathological treatment effect (pTE).
RESULTS: The 5-year CRPC-free survival and cancer-specific survival (CSS) rates were 50.8% and 77.0%, respectively. Biopsy GG 5 was associated with adverse outcomes, whereas pTE grade ≥ 2 was significantly associated with favorable outcomes, including improved CSS. Biopsy GG 5 was the sole preoperative factor associated with pTE. The rate of major perioperative complications (Clavien-Dindo grade ≥ 3) was 1.6%, underscoring the safety of cRP in this setting.
CONCLUSION: Cytoreductive radical prostatectomy (cRP) appears to be a feasible and safe local treatment option in selected patients with mCSPC. In addition to cytoreductive benefit, cRP provides critical pathological information-particularly pTE-that correlates strongly with survival outcomes but cannot be predicted preoperatively. These findings support the incorporation of cRP as a diagnostic and therapeutic component within a multimodal treatment strategy for mCSPC.
METHOD: We retrospectively analyzed 61 patients with mCSPC who underwent cRP following neoadjuvant androgen deprivation therapy (ADT). Clinical, perioperative, and pathological parameters were reviewed. Survival outcomes were assessed in relation to biopsy Gleason grade (GG), metastatic burden, PSA dynamics, and pathological treatment effect (pTE).
RESULTS: The 5-year CRPC-free survival and cancer-specific survival (CSS) rates were 50.8% and 77.0%, respectively. Biopsy GG 5 was associated with adverse outcomes, whereas pTE grade ≥ 2 was significantly associated with favorable outcomes, including improved CSS. Biopsy GG 5 was the sole preoperative factor associated with pTE. The rate of major perioperative complications (Clavien-Dindo grade ≥ 3) was 1.6%, underscoring the safety of cRP in this setting.
CONCLUSION: Cytoreductive radical prostatectomy (cRP) appears to be a feasible and safe local treatment option in selected patients with mCSPC. In addition to cytoreductive benefit, cRP provides critical pathological information-particularly pTE-that correlates strongly with survival outcomes but cannot be predicted preoperatively. These findings support the incorporation of cRP as a diagnostic and therapeutic component within a multimodal treatment strategy for mCSPC.