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Treatment of Oligometastatic Hormone-Sensitive Prostate Cancer: A Comprehensive Review

Authors
 Kyo Chul Koo  ;  Prokar Dasgupta 
Citation
 YONSEI MEDICAL JOURNAL, Vol.59(5) : 567-579, 2018 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2018
MeSH
Combined Modality Therapy ; Humans ; Lymph Node Excision/methods* ; Male ; Neoplasm Metastasis/therapy* ; Palliative Care ; Prostatectomy* ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy* ; Prostatic Neoplasms/surgery* ; Quality of Life ; Retrospective Studies ; Treatment Outcome
Keywords
Neoplasm metastasis ; hormones ; oligometastasis ; prostate cancer ; prostatectomy ; radiotherapy
Abstract
With advancements in diagnostic techniques, including molecular and clinical imaging, that directly target cancer cells, oligometastatic prostate cancer (PCa) is being diagnosed in patients who were, in the past, considered to have localized disease. With accumulating evidence, there has been a paradigm shift in considering aggressive treatments targeted at both the primary tumor and metastatic lesions in an aim to avoid and delay the need for palliative treatments and, ultimately, to achieve survival benefits. However, many questions still remain unanswered regarding the understanding of oligometastatic PCa, from its definition to optimal treatment strategies for each individual. Limited retrospective studies have suggested that interventions, including local and/or metastasis-directed therapy using surgery and radiation therapy (RT), can improve survival outcomes with minimal risk of adverse effects. Such treatments have been shown to decrease the risks of subsequent palliative interventions and to delay the start of androgen-deprivation therapy. Nevertheless, available data are insufficient to draw a reliable conclusion regarding their effect on quality of life measures and overall survival. This comprehensive review overviews data from contemporary literature that have investigated treatments, including surgery and RT, for patients with oligometastatic PCa, namely pelvic lymph node positive disease and limited distant metastases, and summarizes ongoing trials that are evaluating the feasibility of aggressive multimodal treatments.
Files in This Item:
T201805351.pdf Download
DOI
10.3349/ymj.2018.59.5.567
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167154
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