Radical prostatectomy in metastatic prostate cancer: is there enough evidence? | Opinion: Yes

Vol. 42 (5): 876-879, September – October, 2016

doi: 10.1590/S1677-5538.IBJU.2016.05.04


DIFFERENCE OF OPINION

Walter Henriques da Costa 1, Gustavo Cardoso Guimarães 1

1 AC Camargo Cancer Center, SP, Brasil


Keywords: Prostatectomy; Prostate; Prostatic Neoplasms


Prostate cancer (PCa) is the most frequent and the second ranked cause of cancer deaths among men each year. The vast majority of patients are diagnosed with localized disease, however it is estimated that 35,000 American men were diagnosed with locally advanced or metastatic prostate cancer (mPCa) in 2015 (1). During the last few years we have seen notable advances in the treatment of mPCa with the introduction of several second-line hormonal therapy options, immunotherapy and cytotoxic chemotherapy in hormone sensitive disease (2). With newer therapies that prolong survival in patients relapsing with mPCa and the increasingly widespread use of prostate-specific antigen (PSA) testing, men with metastatic disease might have lower disease burden at diagnosis than in the past decades (3). Although recent data suggest a relative improvement in 2-year overall survival in mPCa patients treated with systemic therapy, the long-term survival still remains disappointing. Actually, patients with mPCa and non-metastatic PCa present 5-year cancer-specific survival (CSS) rates of 28% and 99%, respectively (4). Thus, there is clearly room for improvement in the treatment of mPCa patients.

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