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<p>Cytoreductive radical prostatectmy (cRP) represents a&#xa0;local therapeutic option in the management of metastatic hormone sensitive prostate cancer (mHSPC), which should be discussed as a&#xa0;treatment alternative to radiation therapy. Indication for cRP needs to be made carefully and the following selection criteria should be respected: low volume metastatic disease, prostate-specific antigen (PSA) decrease to &lt; 0.2 ng/ml or by at least 80% after 6&#xa0;months of induction androgen deprivation therapy (ADT), and absence of significant extraprostatic extension. Despite these selection criteria, significant and metastatic prostate cancer will be identified in the majority of patients underlining the importance of local treatment of the primary in conjunction with combined ADT. Current data from prospective and retrospective studies demonstrate a&#xa0;significant advantage of cRP as compared to combined ADT in terms of metastasis-free, cancer-specific, and overall survival. The median overall survival is 60–80%, tumor-specific survival is 70–80%, and clinical recurrence-free survival is 60–70 months. Surgery-associated morbidity is less than 10% in experienced hands. In addition, study data show that symptomatic local recurrence is minimal after cRP, compared to about 25% in patients undergoing radiotherapy. cRP should be considered as a&#xa0;therapeutic alternative in well-selected patients and it should be discussed in interdisciplinary tumor boards.</p>

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Indikation und Ergebnisse der zytoreduktiven radikalen Prostatektomie

  • 期刊论文

  • 发表日期：

    2025年7月10日

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  • Axel Heidenreich,
  • Constatin Rieger,
  • Julian Heidenreich,
  • David Pfister

摘要

Cytoreductive radical prostatectmy (cRP) represents a local therapeutic option in the management of metastatic hormone sensitive prostate cancer (mHSPC), which should be discussed as a treatment alternative to radiation therapy. Indication for cRP needs to be made carefully and the following selection criteria should be respected: low volume metastatic disease, prostate-specific antigen (PSA) decrease to < 0.2 ng/ml or by at least 80% after 6 months of induction androgen deprivation therapy (ADT), and absence of significant extraprostatic extension. Despite these selection criteria, significant and metastatic prostate cancer will be identified in the majority of patients underlining the importance of local treatment of the primary in conjunction with combined ADT. Current data from prospective and retrospective studies demonstrate a significant advantage of cRP as compared to combined ADT in terms of metastasis-free, cancer-specific, and overall survival. The median overall survival is 60–80%, tumor-specific survival is 70–80%, and clinical recurrence-free survival is 60–70 months. Surgery-associated morbidity is less than 10% in experienced hands. In addition, study data show that symptomatic local recurrence is minimal after cRP, compared to about 25% in patients undergoing radiotherapy. cRP should be considered as a therapeutic alternative in well-selected patients and it should be discussed in interdisciplinary tumor boards.