Cytoreductive Radical Prostatectomy in Men with De Novo Metastatic Prostate Cancer.

Cytoreductive radical prostatectomy (CRP) involves removing the primary tumor in men with de novo metastatic prostate cancer, particularly those with resectable primary, good response to systemic therapy, and good performance status. Emerging evidence suggests CRP may reduce tumor burden, enhance systemic therapy efficacy, and improve survival in select patients. Robot-assisted approaches are increasingly favored for their lower complication rates. CRP can better prevent local complications than radiotherapy but carries higher risks of incontinence and erectile dysfunction. CRP has been shown to be safe in early trials, and is currently being investigated in larger randomized studies to confirm its potential benefits.