Treatment of Primary Tumor in Oligometastatic Prostate Cancer: An Observational Study of the Turkish Urooncology Association Prostate Diseases Working Group

Objective: To report the clinical results of patients who had metastatic prostate cancer (PC) at admission and underwent standard androgen deprivation therapy with radiotherapy (RT) and radical prostatectomy (RP) for the primary tumor. Materials and Methods: This study used the PC database from the Turkish Urooncology Association, to which participating institutions submit online data. The following clinical, radiological, and pathological findings were retrieved from the database: age, total prostate-specific antigen, clinical TNM stage, number of metastases, International Society of Urological Pathology grade group of biopsy, time to castration-resistant disease, type of local treatment, type of staging method, status of survival, type of systemic treatment, and follow-up time. Results: The median follow-up of the 18 included patients was 59.1 (19.9-180) months. RP and extended lymphadenectomy were performed in 12 patients. RT was performed in 6 patients. The median number of metastases was 2 (1-4) and 3 (1-4) in the RP and RT groups, respectively. In the RP group, 3 of 12 patients developed castration-resistant prostate cancer (CRPC) during the follow-up period. In the RT group, 2 of 6 patients developed CRPC in the follow-up period. The time to CRPC was 48.4 and 43.3 months, respectively. Conclusion: While primary tumor-directed RT is effective in selected patients, the results of prospective randomized controlled studies are required to demonstrate the effectiveness of RP