Anna Patrikidou1, Laurent Brureau2, Julien Casenave2, Laurence Albiges1, Mario Di Palma1, Jean-Jacques Patard3, Hervé Baumert4, Pierre Blanchard5, Alberto Bossi5, Kyriaki Kitikidou6, Christophe Massard1, Karim Fizazi1, Pascal Blanchet2, Yohann Loriot7. 1. Department of Cancer Medicine, Gustave Roussy Institute, Cancer Campus, Grand Paris, University of Paris-Sud, Villejuif, France. 2. Department of Urology, University Hospital of Pointe-à-Pitre, France. 3. Department of Urology, Kremlin-Bicêtre Hospital, University of Paris-Sud, Kremlin-Bicêtre, France. 4. Department of Urology, Saint-Joseph Hospital, Paris, France. 5. Department of Radiotherapy, Gustave Roussy Institute, Cancer Campus, Grand Paris, University of Paris-Sud, Villejuif, France. 6. Department of Forestry and Management of the Environment and Natural Resources, School of Agricultural Sciences and Forestry, Democritus University, Alexandroupoli, Greece. 7. Department of Cancer Medicine, Gustave Roussy Institute, Cancer Campus, Grand Paris, University of Paris-Sud, Villejuif, France. Electronic address: yohann.loriot@gustaveroussy.fr.
Abstract
BACKGROUND: The paradigm change observed over the last few years in several solid tumors emphasizes the value of locoregional treatment in the presence of metastatic disease, currently ignored in de novo prostate cancer (CaP). We investigated the effect of the primary tumor that is left untreated on prostate cancer-specific morbidity and mortality, time to castration resistance, and overall survival (OS). METHODS: We performed a bicentric cohort study. The overall population included de novo metastatic CaP managed at the Genito-Urinary Oncology Unit of the Gustave Roussy Institute and the Urology Clinic of the University Hospital of Pointe-à-Pitre, France. Descriptive statistical and outcome analyses were performed in the overall cohort and also separately in the N+M0 and M+subgroups. RESULTS: The overall cohort included 263 patients. Approximately two-thirds of patients (64%) presented with locoregional symptoms at diagnosis, and 78% throughout the disease. Of the symptomatic patients, 59% required a locoregional procedure. Median OS of patients with locoregional symptoms at diagnosis was shorter than in those who were asymptomatic (47 vs. 86 mo, P = 0.0007); this difference was maintained in the N+M0 and M+subgroups. Median OS and time to castration resistance showed a nonsignificant trend in favor of patients undergoing a locoregional treatment at diagnosis. CONCLUSION: The presence of symptoms due to locoregional disease in de novo metastatic CaP entails significant morbidity and even mortality and requires active management. Randomized prospective trials are needed to evaluate the role of initial definite locoregional treatment in these patients.
BACKGROUND: The paradigm change observed over the last few years in several solid tumors emphasizes the value of locoregional treatment in the presence of metastatic disease, currently ignored in de novo prostate cancer (CaP). We investigated the effect of the primary tumor that is left untreated on prostate cancer-specific morbidity and mortality, time to castration resistance, and overall survival (OS). METHODS: We performed a bicentric cohort study. The overall population included de novo metastatic CaP managed at the Genito-Urinary Oncology Unit of the Gustave Roussy Institute and the Urology Clinic of the University Hospital of Pointe-à-Pitre, France. Descriptive statistical and outcome analyses were performed in the overall cohort and also separately in the N+M0 and M+subgroups. RESULTS: The overall cohort included 263 patients. Approximately two-thirds of patients (64%) presented with locoregional symptoms at diagnosis, and 78% throughout the disease. Of the symptomatic patients, 59% required a locoregional procedure. Median OS of patients with locoregional symptoms at diagnosis was shorter than in those who were asymptomatic (47 vs. 86 mo, P = 0.0007); this difference was maintained in the N+M0 and M+subgroups. Median OS and time to castration resistance showed a nonsignificant trend in favor of patients undergoing a locoregional treatment at diagnosis. CONCLUSION: The presence of symptoms due to locoregional disease in de novo metastatic CaP entails significant morbidity and even mortality and requires active management. Randomized prospective trials are needed to evaluate the role of initial definite locoregional treatment in these patients.
Authors: Sebastian Frees; Shusuke Akamatsu; Samir Bidnur; Daniel Khalaf; Claudia Chavez-Munoz; Werner Struss; Bernhard J Eigl; Martin Gleave; Kim N Chi; Alan So Journal: World J Urol Date: 2018-02-27 Impact factor: 4.226
Authors: Diletta Bianchini; David Lorente; Pasquale Rescigno; Zafeiris Zafeiriou; Elena Psychopaida; Hazel O'Sullivan; Mervyn Alaras; Michael Kolinsky; Semini Sumanasuriya; Mariane Sousa Fontes; Joaquin Mateo; Raquel Perez Lopez; Nina Tunariu; Nikolaos Fotiadis; Pardeep Kumar; Alison Tree; Nicholas Van As; Vincent Khoo; Chris Parker; Rosalind Eeles; Alan Thompson; David Dearnaley; Johann S de Bono Journal: Clin Genitourin Cancer Date: 2017-04-26 Impact factor: 2.872
Authors: Martin J Connor; Taimur T Shah; Gail Horan; Charlotte L Bevan; Mathias Winkler; Hashim U Ahmed Journal: Nat Rev Clin Oncol Date: 2019-11-11 Impact factor: 66.675