Cytoreductive radical prostatectomy (cRP) following neoadjuvant androgen-deprivation therapy for men with hormone-naïve low-volume metastatic prostate cancer (mhnPCA) has long-term survival and other benefits, according to study findings presented as part of the American Urological Association 2020 Virtual Experience.
The finding is from a study that included 32 patients with mhnPCA who underwent cRP following 6 months of neoadjuvant androgen-deprivation therapy (ADT) and 38 case-matched patients with mhnPCA who received only 6 months of neoadjuvant ADT. All men had low-volume skeletal metastases (3 lesions or fewer on bone scans) with no visceral or retroperitoneal lymph node metastases, and a PSA decrease of less than 1.0 ng/mL following 6 months of ADT.
After a median follow-up of 75.5 months, 27 patients (84.4%) were alive, Patricia John, MD, and colleagues at the University of Cologne in Köln, Germany, reported in a study abstract. Of these, 16 (59.2%) progressed to metastatic castration-resistant prostate cancer. The median overall survival (OS) time was 78.9 months, and the median time to castration-resistant disease was 40 months.
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OS, progression-free survival, and time to castration-resistant disease were significantly greater in the cRP group than the ADT monotherapy arm. Locally symptomatic relapses occurred in none of the cRP recipients compared with 12 patients (31.6%) of the ADT-only arm.
“Although data from prospective randomized trials are lacking, cRP should be considered as a valid treatment option in well selected patients with low volume metastatic disease and good response to neoadjuvant ADT,” the investigators concluded.
Reference
John P, Pfister D, Heidenreich A, Hartmann F. Long-term results of cytoreductive radical prostatectomy in men hormone-naive, low volume metastatic prostate cancer (MHNPCA). Presented at the American Urological Association 2020 Virtual Experience held in May. Abstract MP79-16.
