Radical prostatectomy in metastatic prostate cancer: is there enough evidence? | Opinion: No

Vol. 42 (5): 880-882, September – October, 2016

doi: 10.1590/S1677-5538.IBJU.2016.05.05


DIFFERENCE OF OPINION

Benjamin T. Ristau 1, Marc C. Smaldone 1

1 Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA


Keywords: Prostatectomy; Prostate; Prostatic Neoplasms


Despite an absence of level I data suggesting a survival benefit, interest in radical prostatectomy (RP) for patients with metastatic prostate cancer (PC) is rising (1). Traditionally, RP has been reserved for clinically localized PC, and good outcomes have been demonstrated in this population (2). While both retrospective and observational studies have reported improved survival outcomes for patients with metastatic (M1) disease who undergo primary tumor treatment relative to androgen deprivation therapy alone (1, 3), prospective data – particularly for surgery – is sparse. It would be unwise, then, to prematurely extrapolate these results to patients with metastatic disease until the merits of such an approach are carefully considered.

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