Modern approaches to local treatment of metastatic prostate cancer (literature review)

Authors

DOI:

https://doi.org/10.26641/2307-5279.25.2.2021.238240

Keywords:

metastatic prostate cancer, primary treatment, local treatment, radical prostatectomy, radiotherapy, cytoreductive treatment

Abstract

The potential oncological benefit of modern technological, laboratorial and imaging studies significantly improved disease-free survival rates in patients suffering from prostate cancer (PCa). Systematic reviews carried out in men with metastatic prostate cancer (mPCa) identify plenty of studies, especially dedicated to local treatment options. Unfortunately, young and fit patients with mPCa at diagnosis present unexpected resistance towards proposed treatment. Oncological outcomes demonstrate high rate of cancer-specific and overall mortality with precursory invasion of adjacent structures and impaired quality of life in patients.

Current literature review was carried out using mainly PubMed and SciELO database to identify and analyze advances of local treatment of mPCa. The most relevant articles included studies performed from March 2005 to November 2020.

According to the last brief reviews, main indication for providing primary treatment of PCa includes nonmetastatic PCa. Additionaly, it may be performed as palliative treatment for mPCa to minimize local invasion, prevent arising of new metastasis and provide better biological answer of chemotherapy and hormonal treatment. Recent data suggests that local treatment and overall survival turned out to be more effective in patients under 70 years. Thus, independent negative prognostic factors mentioned in patients with mPCa are age above 70 years, cT4 stage or high-grade disease, PSA і 20 ng/ml, and pelvic lymphadenopathies. While comparing patients who underwent local treatment with those one who did not, the presence of these 3 or more CSS and OS factors conditions remains the same. Metastasis degree and location number can also influence outcome. Furthermore, visceral metastases lead to worse prognosis.

Exploring new treatment options for mPCa awoke interest in scientists in recent years. Radical prostatectomy and target radiation therapy remain the most effective in achieving local disease control and, thus, control of systemic disease. There is growing evidence supporting local treatment in cases of metastatic prostate cancer at diagnosis in the context of a multimodal approach. However, its oncological effect requires prospective studies with well-defined patient selection criteria. Prospective multicentric studies might sustain the existing data and define the main indications for primary treatment in mPCa.

References

Siegel R., Naishadham D., Jemal A. Cancer statistics. CA Cancer J Clin. 2013. Vol. 63(1). P. 11–30.

Cooperberg M.R., Vickers A.J., Broering J.M., Carroll P.R. Comparative risk-adjusted mortality outcomes after primary surgery? Radiotherapy, or androgen-deprivation therapy for localized prostate cancer. Cancer. 2010. Vol. 116. P. 5226–5234.

Xu N., Wu Y.P., Ke Z.B. et al. Risk factors of developing visceral metastases at diagnosis in prostate cancer patients. Translational Cancer Research. 2019. Vol. 8(3). P. 928–938.

Yossepowitch O. et al. Radical prostatectomy for clinically localized high risk prostate cancer: critical analisis of risk assessment methods. J Urol. 2007. Vol. 178. P. 493–499.

Fossa S.D. et al. Ten- and 15-year prostate cancer-specific mortality in patients with nonmetastatic locally advanced or aggressive intermediate prostate cancer, randomized to lifelong endocrine treatment alone or combined with radiotherapy: final results oft he Scandinavian Prostate Cancer Groupe-7. Eur Urol. 2016. Vol. 70. P. 684–691.

Johnston T.J. et al. Mortality among men with advanced prostate cancer excluded from the Protect trial. Eur Urol. 2017. Vol. 71. P. 381–388.

Stattin P. et al. Association of radical local treatment with mortality in men with very high-risk prostate cancer: a semiecologic, nationwide, population-based study. Eur Urol. 2017. Vol. 72. P. 125–134.

James D.N. et al. Failure-free survival and radiotherapy in patients with newly diagnosed nonmetastatic prostate cancer: data from patients in the control arm of the STAMPEDE trial. JAMA Oncol. 2016. Vol. 2(3). P. 348–357.

Almeida P.L., Pereira B.J. Local treatment of metastatic prostate cancer: what is evidence so far? Prostate cancer. 2018. Vol. 3. P. 1–7.

Filippou P., Ferguson J.E., Nielsen M.E. Epidemiology of Prostate and Testicular Cancer. Seminars in Interventional Radiology. 2016. Vol. 33(3). P. 182–185.

Antwi S., Everson T.M. Prognostic impact of definitive local therapy of the primary tumor in men with metastatic prostate cancer at diagnosis: A population-based, propensity score analysis. Cancer Epidemiology. 2014. Vol. 38(4). P. 435–441.

Bayne C.E., Williams S.B., Cooperberg M.R. et al. Treatment of the primary tumor in metastatic prostate cancer: current concepts and future perspectives. Eur Urol. 2016. Vol. 69(5). P. 775–787.

Mathieu R., Korn K., Bensalah K., Kramer G., Shariat S.E. Cytoreductive radical prostatectomy in metastatic prostate cancer: Does it really make sense? World Journal of the Urology. 2016. Vol. 12. P. 1–11.

Canby-Hagino E., Swanson G., Crawford E., Basler J., Hernandes J., Thompson I. Local and systemic therapy for patients with metastatic prostate cancer: should the primary be treated? Current prostate reports. 2005. Vol. 3. P. 153–155.

Piper C., Porres D., Pfister D., Heidenreich A. The role of palliative surgery in castration-resistant prostate cancer. Current Opinion in supportive and palliative care. 2014. Vol. 8(3). P. 250–257.

Gundem G., van Loo P., Kremeyer B., Alexandrov L.B., Tubio J.M.C., Papaemmanuil E. et al. The evolutional history of lethal metastatic prostate cancer. Nature. 2015. Vol. 520 (7547). P. 353–357.

Swanson G., Thompson I., Basler J., Crawford E.D. Metastatic prostate cancer - does treatment of the primary tumor matter? J Urol. 2006. Vol. 176(4). P. 1292–1298.

Kim M.Y., Oskarsson T., Acharyya S. et al. Tumor self-seeding by circulating cancer cells. Cell. 2009. Vol. 139(70). P. 1315–1326.

Arcangeli S., Zilli T., De Bari B., Alongi F. Hit the primary: A paradigm shift in the treatment of metastatic prostate cancer? Critical Review in Oncology/Hematology. 2016. Vol. 97. P. 231–237.

Culp S.H., Schellhammer P.F., Williams M.B. Might men diagnosed with metastatic prostate cancer benefit from definitive treatment of the primary tumor? A SEER-based study. Eur Urol. 2014. Vol. 65(6). P. 1058–1066.

Loppenberg B., Dalela D., Karabon P., Sood A., Sammon D.J., Meyer C.P. et al. The impact of local treatment on overall survival in patients with metastatic prostate cancer on diagnosis: a national cancer data base analysis. Eur Urol. 2017. Vol. 72(1). P. 14–19.

Satkunasivam R., Kim A.E., Desai M., Nguyen M.M., Quinn D.I., Ballas L. et al. Radical prostatectomy or external beam radiation therapy vs no local therapy for survival benefit in metastatic prostate cancer: A SEER-Medicare analysis. J Urol. 2015. Vol. 194(2). P. 378–385.

Cho Y., Chang J.S., Rha K.H. et al. Does radiotherapy for the primary tumor benefit prostate cancer patients with distant metastasis at initial diagnosis? PLoS ONE. 2016. Doi: 10.1371/journal.pone.0147191.

Rusthoven C.G., Jones B.L., Flaig T.W. et al. Improved survival with prostate radiation in addition to androgen deprivation therapy for men with newly diagnosed metastatic prostate cancer. J Clin Oncol. 2016. Vol. 34(24). P. 2835–2842.

Heidenreich A., Pfister D., Porres D. Cytoreductive radical prostatectomy in patients with prostate cancer and low volume skeletal metastases: results of a feasibility and case-control study. J Urol. 2016. Vol. 193(3). P. 832–838.

Kaplan R.N., Rafii S., Lyden D. Preparing the “soil”: the premetastatic niche. Cancer Research. 2006. Vol. 66(23). P. 11089–11093.

Reeves F., Costello A.J. Is there a place for cytoreduction in metastatic prostate cancer? BJU International. 2015. Vol. 118(1). P. 14–15.

Weckermann D., Polzer B., Ragg T., Blana A., Schlimok G., Arnholdt H. et al. Perioperative activation of disseminated tumor cells in bone marrow of patients with prostate cancer. J Clin Oncol. 2009. Vol. 27(10). P. 1549–1556.

Folkersma L.R., Manso L.S.J., Romo I.G., Sierra J.M., Gomes C.O. Prognostic significance of circulating tumor cell count in patients with metastatic hormone-sensitive prostate cancer. Urology. 2012. Vol. 80. P. 1328–1332.

Won A.C.M., Gurney H., Marx G., De Souza P., Patel M.I. Primary treatment of the prostate improves local palliation in men who ultimately develop castrate-resistant prostate cancer. BJU International. 2013. Vol 112(4). P. E250-E255.

Logothetis C.J., Aparicio M. Is the time to re-examine the prostate cancer treatment paradigm by targeting the interaction between the prostate and metastases? J Clin Oncol. 2016. Vol. 34(24). P. 2810–2811.

Aoun F., Peltier A., van Velthoven R. A comprehensive review of contemporary role of local treatment of the primary tumor and/or the metastasis in metastatic prostate cancer. BioMed Research International. 2014. Doi: 10.1155/2014/501213.

Gratzke C., Engel J., Stief C.G. Role of radical prostatectomy in metastatic prostate cancer: Data from Munich cancer registry. Eur Urol. 2014. Vol. 66(3). P. 602–603.

Heidenreich A., Pfister D. Radical cytoreductive prostatectomy in men with prostate cancer and oligometastatic disease. Current Opinion in Urology. 2020. Vol. 30. P. 90–97.

Published

2021-08-04

Issue

Section

Review of literature