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Oligometastatic Prostate Cancer: A Comparison between Multimodality Treatment vs. Androgen Deprivation Therapy Alone

Authors :
Francesco A. Mistretta
Stefano Luzzago
Andrea Conti
Elena Verri
Giulia Marvaso
Claudia Collà Ruvolo
Michele Catellani
Ettore Di Trapani
Gabriele Cozzi
Roberto Bianchi
Matteo Ferro
Giovanni Cordima
Antonio Brescia
Maria Cossu Rocca
Vincenzo Mirone
Barbara A. Jereczek-Fossa
Franco Nolè
Ottavio de Cobelli
Gennaro Musi
Source :
Cancers; Volume 14; Issue 9; Pages: 2313
Publication Year :
2021

Abstract

Background: We compared multimodality treatment (MMT, defined as robot-assisted radical prostatectomy (RARP) with androgen deprivation therapy (ADT), with or without adjuvant radiotherapy (RT)) vs. ADT alone in oligometastatic prostate cancer (OPC) patients. Methods: From 2010 to 2018, we identified 74 patients affected by cM1a-b OPC (≤5 metastases). Kaplan–Meier (KM) plots depicted cancer-specific mortality (CSM), disease progression, metastatic castration-resistant PC (mCRPC), and time to second-line systemic therapy rates. Multivariable Cox regression models (MCRMs) focused on disease progression and mCRPC. Results: Forty (54.0%) MMT and thirty-four (46.0%) ADT patients were identified. On KM plots, higher CSM (5.9 vs. 37.1%; p = 0.02), mCRPC (24.0 vs. 62.5%; p < 0.01), and second-line systemic therapy (33.3 vs. 62.5%; p < 0.01) rates were recorded in the ADT group. No statistically significant difference was recorded for disease progression. ForMCRMs adjusted for the metastatic site and PSA, a higher mCRPC rate was recorded in the ADT group. No statistically significant difference was recorded for disease progression. Treatment-related adverse events occurred in 5 (12.5%) MMT vs. 15 (44.1%) ADT patients (p < 0.01). Conclusions: MMT was associated with lower CSM, mCRPC, and second-line therapy rates. A lower rate of treatment-related adverse events was recorded for the MMT group.

Details

ISSN :
20726694
Volume :
14
Issue :
9
Database :
OpenAIRE
Journal :
Cancers
Accession number :
edsair.doi.dedup.....6db827d503d3e58a4e4e31bb1f5f9ccf