Novel Insights into the Management of Oligometastatic Prostate Cancer: A Comprehensive Review

Battaglia, Antonino; Meerleer, Gert De; Tosco, Lorenzo; Moris, Lisa; Broeck, Thomas Van den; Devos, Gaëtan; Everaerts, Wouter; Joniau, Steven

doi:10.1016/j.euo.2018.09.005

Cited by 68 publications

(57 citation statements)

References 78 publications

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“…SBRT is most commonly used as a treatment modality of the former approach. Although SBRT for PeNR provides excellent local control, some patients subsequently develop further PeNR, which remains a cause for concern [ 6 ]. In the report regarding MDT for oligo-recurrent PCa, Decaestecker et al.…”

Section: Discussionmentioning

confidence: 99%

Long-term clinical outcomes of salvage pelvic radiation therapy for oligo-recurrent pelvic lymph nodes after definitive external-beam radiation therapy for non-metastatic prostate cancer

Sato

Aizawa

Nakamura

et al. 2020

Journal of Radiation Research

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Abstract Although salvage external-beam radiation therapy (EBRT) is an attractive treatment option for pelvic lymph nodal recurrence (PeNR) in patients with prostate cancer (PCa), limited data are available regarding its long-term efficacy. This study examined the long-term clinical outcomes of patients who underwent salvage pelvic radiation therapy (sPRT) for oligo-recurrent pelvic lymph nodes after definitive EBRT for non-metastatic PCa. Patients who developed PeNR after definitive EBRT and were subsequently treated with sPRT at our institution between November 2007 and December 2015 were retrospectively analyzed. The prescribed dose was 45–50.4 Gy (1.8–2 Gy per fraction) to the upper pelvis, with up to 54–66 Gy (1.8–2 Gy per fraction) for recurrent nodes. Long-term hormonal therapy was used as neoadjuvant and/or adjuvant therapy. The study population consisted of 12 consecutive patients with PeNR after definitive EBRT (median age: 73 years). The median follow-up period was 58.9 months. The 5-year overall survival, PCa-specific survival, biochemical failure-free, clinical failure-free, and castration-resistant PCa-free rates were 82.5, 100.0, 62.3, 81.8, and 81.8%, respectively. No grade 2 or higher sPRT-related late toxicities occurred. In conclusion, more than half of the study patients treated with sPRT had a long-term disease-free status with acceptable morbidities. Moreover, most of the patients maintained hormonal sensitivity. Therefore, this approach may be a promising treatment method for oligo-recurrent pelvic lymph nodes.

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Section: Discussionmentioning

confidence: 99%

Long-term clinical outcomes of salvage pelvic radiation therapy for oligo-recurrent pelvic lymph nodes after definitive external-beam radiation therapy for non-metastatic prostate cancer

Sato

Aizawa

Nakamura

et al. 2020

Journal of Radiation Research

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“…Metastasis-directed therapy (MDT) has not been a standard of treatment for recurrent PCa; however, growing evidence suggests that MDT may be beneficial to manage patients with oligometastases. 3,4 Mosca et al reported a case of curative lung metastasectomy without concomitant ADT in oligometastatic castration-resistant PCa. Histopathologic examination of the resected lung showed a neuroendocrine differentiation.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…1,2 Takamori et al reported a very rare case of prostate cancer recurrence that seemed to be surrounded by seminal vesicle/ vas deferens-like epithelium after radiation therapy. 3 Based on the previous report, congenital cystic anomalies of the seminal vesicle may be classified in to three groups, such as (i) isolated cyst, (ii) cysts associated with upper urinary tract anomalies, and (iii) cysts associated with autosomal dominant polycystic kidney disease. During development, cysts of the seminal vesicle emerge when one is in their 20s and become sexually active.…”

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confidence: 99%

Editorial Comment from Dr Suzuki to Solitary recurrence of prostate cancer surrounded by seminal vesicle/vas deferens‐like epithelium

Suzuki

2020

IJU Case Reports

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“…Recent favorable developments using combined therapy for oligometastatic disease are also being investigated. 90 TRUS has been used for the evaluation of local recurrence. However, the altered anatomy of the region, the development of fibrotic tissue, the fact that 30% of recurrent tumors may be isoechoic, and that some lesions are in an anterior position or extend along the bladder wall influence the accuracy of this modality.…”

Section: Recurrent Prostate Cancermentioning

confidence: 99%

Magnetic Resonance–Guided Prostate Ablation

Woodrum

Kawashima

Gorny

et al. 2019

Semin intervent Radiol

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In 2019, the American Cancer Society (ACS) estimates that 174,650 new cases of prostate cancer will be diagnosed and 31,620 will die due to the prostate cancer in the United States. Prostate cancer is often managed with aggressive curative intent standard therapies including radiotherapy or surgery. Regardless of how expertly done, these standard therapies often bring significant risk and morbidity to the patient's quality of life with potential impact on sexual, urinary, and bowel functions. Additionally, improved screening programs, using prostatic-specific antigen and transrectal ultrasound-guided systematic biopsy, have identified increasing numbers of low-risk, low-grade “localized” prostate cancer. The potential, localized, and indolent nature of many prostate cancers presents a difficult decision of when to intervene, especially within the context of the possible comorbidities of aggressive standard treatments. Active surveillance has been increasingly instituted to balance cancer control versus treatment side effects; however, many patients are not comfortable with this option. Although active debate continues on the suitability of either focal or regional therapy for the low- or intermediate-risk prostate cancer patients, no large consensus has been achieved on the adequate management approach. Some of the largest unresolved issues are prostate cancer multifocality, limitations of current biopsy strategies, suboptimal staging by accepted imaging modalities, less than robust prediction models for indolent prostate cancers, and safety and efficiency of the established curative therapies following focal therapy for prostate cancer. In spite of these restrictions, focal therapy continues to confront the current paradigm of therapy for low- and even intermediate-risk disease. It has been proposed that early detection and proper characterization may play a role in preventing the development of metastatic disease. There is level-1 evidence supporting detection and subsequent aggressive treatment of intermediate- and high-risk prostate cancer. Therefore, accurate assessment of cancer risk (i.e., grade and stage) using imaging and targeted biopsy is critical. Advances in prostate imaging with MRI and PET are changing the workup for these patients, and advances in MR-guided biopsy and therapy are propelling prostate treatment solutions forward faster than ever.

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Novel Insights into the Management of Oligometastatic Prostate Cancer: A Comprehensive Review

Cited by 68 publications

References 78 publications

Long-term clinical outcomes of salvage pelvic radiation therapy for oligo-recurrent pelvic lymph nodes after definitive external-beam radiation therapy for non-metastatic prostate cancer

Long-term clinical outcomes of salvage pelvic radiation therapy for oligo-recurrent pelvic lymph nodes after definitive external-beam radiation therapy for non-metastatic prostate cancer

Editorial Comment from Dr Suzuki to Solitary recurrence of prostate cancer surrounded by seminal vesicle/vas deferens‐like epithelium

Magnetic Resonance–Guided Prostate Ablation

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