Does robot‐assisted radical prostatectomy benefit patients with prostate cancer and bone oligometastases?

Abstract

We showed that RARP in the setting of oligometastatic PCa is a safe and feasible procedure which improves oncological outcomes in terms of PFS and CSS. In addition, our data suggest that RARP effectively prevents urinary tract complications from PCa. The study highlights results from expert surgeons and highly selected patients that cannot be extrapolated to all patients with oligometastatic PCa; to confirm our findings, large, prospective, multicentre studies are required.

Is it time for a more ‘proactive’ approach to metastatic prostate cancer?

“…The present study by Jang et al. adds to the growing body of retrospective series advocating cRP in select patients.…”

“…Understandably, the current manuscript by Jang et al. also suffers from some of these limitations and leaves some questions unanswered. For instance, did the number of bone metastases, PSA doubling time at diagnosis, and distribution of lymphadenopathy (pelvic vs extra‐pelvic) differ between cRP and ADT groups and thus confound the impact of cRP on survival?…”

“…However, it is important to note that Jang et al. had a 79% positive margin rate compared to 54% for Sooriakumaran et al. .…”

“…Furthermore, Jang et al. had a median hospital stay of 5 days compared to 2–3 days in the USA centres . These findings underscore the significant difficulty often encountered in metastatic cases, despite robotic assistance.…”

“…In this issue of BJU International , Jang et al. investigate the perioperative and oncological outcomes of robot‐assisted radical prostatectomy (RARP) in oligometastatic prostate cancer. The authors evaluated a retrospective cohort of 79 patients with oligometastatic prostate cancer, defined as up to five bony metastases on bone scan without visceral metastasis on conventional CT, treated either with RARP ( n = 38, 48%) or androgen‐deprivation therapy (ADT: n = 41, 52%).…”