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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Genitourinary Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1475914

Improved survival of patients with newly diagnosed oligometastatic prostate cancer through intensified multimodal treatment

Provisionally accepted
Viktoria Schütz Viktoria Schütz 1*Christopher-Leo Nessler Christopher-Leo Nessler 1Anette Duensing Anette Duensing 1,2Stefanie Zschäbitz Stefanie Zschäbitz 3Dirk Jäger Dirk Jäger 3Jürgen Debus Jürgen Debus 4Markus Hohenfellner Markus Hohenfellner 1Stefan Duensing Stefan Duensing 1,5
  • 1 Department of Urology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
  • 2 Precision Oncology of Urological Malignancies, Department of Urology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
  • 3 Department of Medical Oncology, National Center for Tumor Diseases Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
  • 4 Department of Radiation Oncology and Radiation Therapy, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
  • 5 Molecular Urooncology, Department of Urology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany

The final, formatted version of the article will be published soon.

    The standard of care for patients with metastatic hormone-sensitive prostate cancer (mHSPC) includes androgen deprivation therapy (ADT), novel antihormonal therapies (NHT) and/or chemotherapy. Patients with newly diagnosed oligometastatic prostate cancer (omPCa) represent a special subgroup of mHSPC, for which the optimal treatment, particularly the role of radical prostatectomy (RP) and metastasis-directed therapy (MDT), is currently under debate.In this single center, retrospective analysis, 43 patients with newly diagnosed omPCa were included. All patients underwent RP as part of a multimodal, personalized treatment approach. Other treatments included ADT, NHT, MDT (surgery or radiotherapy), adjuvant radiotherapy (prostatic fossa and/or pelvic lymph nodes) or chemotherapy in various combinations.Clinical endpoints were progression free and cancer specific survival (PFS, CSS).No patient with omPCa died from prostate cancer during an up to ten years follow-up period after intensified multimodal treatment i.e., RP, ADT, adjuvant radiation therapy and MDT (n=13). In contrast, patients requiring chemotherapy (n=10) showed a significantly worse PFS (p<0.001) and CSS (p<0.001). Patients receiving various combinations (<4 therapeutic modalities; n=20) showed a more favorable outcome than patients receiving chemotherapy, but differences in PFS and CSS were not statistically significant compared to patients receiving an intensified multimodal treatment.Conclusions: An intensified, multimodal treatment approach including RP can lead to excellent survival outcomes in patients with newly diagnosed omPCa. Patients requiring chemotherapy have most likely a more aggressive disease and therefore a more rapid tumor progression. Future studies to identify markers for risk stratification in patients with omPCa are therefore needed.

    Keywords: Oligometastatic prostate cancer, Radical Prostatectomy, Multimodal treatment, intensified treatment, prostate cancer, hormone sensitive prostate cancer Zschäbitz, JÄGER, Duensing A.

    Received: 04 Aug 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Schütz, Nessler, Duensing, Zschäbitz, Jäger, Debus, Hohenfellner and Duensing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Viktoria Schütz, Department of Urology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany

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