Multimodality treatment (MMT) for men with oligometastatic prostate cancer (PCa) is associated with better oncologic outcomes compared with standard of care, according to new study data presented at the European Association of Urology 2020 virtual congress.

The study, by Francesco Alessandro Mistretta, MD, of the European Institute of Oncology (IEO) IRCCS, in Milan, Italy, and colleagues, included 74 patients with oligometastatic PCa, defined as 5 or few bone lesions found on preoperative imaging. Of these, 40 (54%) received MMT, which consisted of robot-assisted radical prostatectomy (RARP) with extended pelvic lymphadenectomy and adjuvant androgen deprivation (ADT) therapy with or without radiation therapy, and 34 (46%) received ADT alone.

Compared with the MMT group, the ADT-only group had significantly higher rates of cancer-specific mortality (37.1% vs 5.9%), metastatic castration-resistant PCa (62.5% vs 24.0%), and second-line treatment (62.5% vs 33.3%), Dr Mistretta’s team reported.

Preoperatively, the ADT-only group had significantly higher median PSA levels than the MMT group (87 vs 14 ng/mL). The treatment arms were otherwise similar with respect to median age, Charlson comorbidity index, and other clinical variables.


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Multivariable Cox regression models showed no significant difference in rates of disease progression between the treatment groups.

Treatment-related adverse events were significantly more frequent in the ADT-only arm than in the MMT arm (44.1% vs 12.5%), according to the investigators.

Reference

Mistretta FA, Colla Ruvolo C, Conti A, et al. Oligometastatic prostate cancer: multimodality treatment vs standard of care. Presented at: EAU20 Virtual Congress; July 17 to 19, 2020. Abstract 922.