Role of Cytoreductive Radical Prostatectomy in the Treatment of Metastatic Prostate Cancer
Journal of Urologic Oncology 2020³â 18±Ç 3È£ p.161 ~ p.169
¼º¶ôÈñ(Sung Luck-Hee) - Inje University Sanggye Paik Hospital Department of Urology
À°Çüµ¿(Yuk Hyeong-Dong) - Seoul National University Hospital Department of Urology
Abstract
There is controversy regarding the survival benefits of eliminating primary tumors via cytoreductive radical prostatectomy (CRP) in patients with metastatic prostate cancer (mPCa). The purpose of this article is to review the theoretical background of and rationale for CRP, and the current knowledge base. The Scopus and PubMed databases were searched for studies investigating CRP published between January 2000 and October 2019. The retrieved articles were nonsystematically reviewed. Based on preclinical data, retrospective patient case studies, retrospective population-based studies, and prospective studies, CRP has been reported to afford benefits for the treatment and prevention of local symptoms through the removal of primary tumors, and the management of neo-metastatic disease and overall survival. However, despite the results from these studies, the current review mostly addresses small case studies and uncontrolled population-based studies with weak evidence. Based on this weak evidence, therefore, clinical use has not yet been recommended. Further research investigating the role and timing of CRP in patients with mPCa is needed, in addition to studies screening the most suitable populations for CRP.
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Cytoreductive radical prostatectomy, Local treatment, Metastatic prostate cancer, Prostate cancer, Radical prostatectomy.
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À¯È¿¼º°á°ú(Recomendation)
CRP for mPCa has been reported to confer benefits for the treatment and prevention of local symptoms and im-provement of survival outcomes through the removal of pri-mary tumors, the management of neo-metastatic disease, the control of tumor burden. However, the rationale for CRP is based mainly on preclinical and retrospective studies, without large-scale prospective and randomized controlled trials.