ORIGINAL ARTICLE

Does surgery benefit patients with oligometastatic or metastatic prostate cancer? – A retrospective cohort study and meta-analysis

Shubin Si MD

The School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

Department of Urology, People's Hospital of Yiyuan County, Zibo, Shandong, China

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Bin Zheng MD,

Bin Zheng MD

orcid.org/0000-0001-8334-0833

The School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

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Zhenlin Wang MD,

Zhenlin Wang MD

Department of Urology, Lingcheng People's Hospital, Dezhou, Shandong, China

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Zhihong Niu MD, PhD,

Corresponding Author

Zhihong Niu MD, PhD

[email protected]

The School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

Correspondence Zhihong Niu, MD, PhD, Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan city by the five weft seven road, No. 324, Jinan 250021, Shandong, China

Email: [email protected]

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Shubin Si MD,

Shubin Si MD

The School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

Department of Urology, People's Hospital of Yiyuan County, Zibo, Shandong, China

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Bin Zheng MD,

Bin Zheng MD

orcid.org/0000-0001-8334-0833

The School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

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Zhenlin Wang MD,

Zhenlin Wang MD

Department of Urology, Lingcheng People's Hospital, Dezhou, Shandong, China

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Zhihong Niu MD, PhD,

Corresponding Author

Zhihong Niu MD, PhD

[email protected]

The School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

Email: [email protected]

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First published: 31 May 2021

https://doi.org/10.1002/pros.24170

Citations: 5

Shubin Si and Bin Zheng contributed equally to this study.

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Abstract

Background

To evaluate long-term oncological outcomes of radical prostatectomy (RP) plus androgen deprivation therapy (ADT) in oligometastatic prostate cancer (PCa) patients.

Methods

Our study included oligometastatic PCa patients hospitalized between January 1, 2010 and December 31, 2015, who received ADT with or without RP. We evaluated survival by employing Kaplan–Meier methods, with log-rank tests and univariate and multivariate Cox regression analyses. A meta-analysis of previously published studies was additionally performed.

Results

The median follow-up times of both groups were 68.4 months (interquartile range = 56.5–85.0). In this cohort study, significant statistical difference in preoperative total prostate-specific antigen (tPSA; p = .121), clinical T stage (p = .115), and N stage (p = .394) were not found between the two groups. Meanwhile, the difference in overall survival (OS) between the two groups did not reach statistical significance (p = .649). A significant difference was not observed in castration-resistant prostate cancer (CRPC)-free survival between two groups as well (p = .183). Numbers of metastases might be an independent prognosis factor (p = .05) for OS, and postoperative tPSA is a risk predictor for CRPC-free survival (p = .032). A meta-analysis of four relevant studies demonstrated significant statistical difference in clinical improvement with RP plus ADT over ADT alone in OS survival (p < .001; hazard ratio [HR] = 0.51; 95% confidence interval [CI] = 0.38–0.69) instead of CRPC-free survival (p = .42; HR = 0.86; 95% CI = 0.59–1.24).

Conclusion

The addition of RP to ADT for the treatment of oligometastatic PCa was associated with an improved OS instead of CRPC-free survival.

Open Research

DATA AVAILABILITY STATEMENT

The data sets analyzed during the current study are available from the corresponding author's reasonable request.

Supporting Information

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Citing Literature

Volume81, Issue11

August 1, 2021

Pages 736-744

Filename	Description
pros24170-sup-0001-supplementary_Figure1.tif371.6 KB	Supporting information.
pros24170-sup-0002-supplementary_Figure2.tif193 KB	Supporting information.
pros24170-sup-0003-supplementary_Table_1.docx13.9 KB	Supporting information.

Does surgery benefit patients with oligometastatic or metastatic prostate cancer? – A retrospective cohort study and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Information

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Does surgery benefit patients with oligometastatic or metastatic prostate cancer? – A retrospective cohort study and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Related

Information