Metastatic Prostate Cancer-Does Treatment of the Primary Tumor Matter?

Gregory P Swanson, Ian Thompson, Joseph W Basler, E. David Crawford

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: In recent years there has been increased interest in adjuvant therapy for prostate cancer. This trend has engendered a tendency toward overlooking the issue of therapy to the primary tumor in advanced disease. We reviewed the effect of treating the principal disease bulk on overall treatment outcome in patients with advanced and metastatic cancer. Specifically we evaluated the role of surgical tumor cytoreduction. Materials and Methods: We performed a comprehensive literature review to evaluate the role of surgical debulking on the outcome of advanced cancer, including any published evidence supporting a benefit of this therapy for prostate cancer. Results: Even in cancers for which adjuvant chemotherapy and radiation are used liberally there is a clear benefit to optimal surgical debulking for local control and survival. The beneficial role of maximal surgical cytoreduction has been clearly demonstrated in advanced ovarian cancer and gastrointestinal carcinomatosis. Maximal debulking of brain, liver and lung metastasis has translated into longer survival. Removal of the primary tumor has been proved to increase survival in randomized trials of metastatic renal cell cancer. It appears that patients with node positive and possibly metastatic prostate cancer have a better response to androgen ablation with surgical removal of the gland. Conclusions: Surgical cytoreduction of cancer results in a more favorable and durable response to systemic therapy. It is reasonable to explore aggressive surgical therapy for advanced prostate cancer.

Original languageEnglish (US)
Pages (from-to)1292-1298
Number of pages7
JournalJournal of Urology
Volume176
Issue number4
DOIs
StatePublished - Oct 2006

Fingerprint

Prostatic Neoplasms
Neoplasms
Therapeutics
Survival
Adjuvant Chemotherapy
Renal Cell Carcinoma
Ovarian Neoplasms
Androgens
Radiation
Neoplasm Metastasis
Carcinoma
Lung
Liver
Brain

Keywords

  • prostate
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Swanson, G. P., Thompson, I., Basler, J. W., & Crawford, E. D. (2006). Metastatic Prostate Cancer-Does Treatment of the Primary Tumor Matter? Journal of Urology, 176(4), 1292-1298. https://doi.org/10.1016/j.juro.2006.06.069

Metastatic Prostate Cancer-Does Treatment of the Primary Tumor Matter? / Swanson, Gregory P; Thompson, Ian; Basler, Joseph W; Crawford, E. David.

In: Journal of Urology, Vol. 176, No. 4, 10.2006, p. 1292-1298.

Research output: Contribution to journalArticle

Swanson, GP, Thompson, I, Basler, JW & Crawford, ED 2006, 'Metastatic Prostate Cancer-Does Treatment of the Primary Tumor Matter?', Journal of Urology, vol. 176, no. 4, pp. 1292-1298. https://doi.org/10.1016/j.juro.2006.06.069
Swanson, Gregory P ; Thompson, Ian ; Basler, Joseph W ; Crawford, E. David. / Metastatic Prostate Cancer-Does Treatment of the Primary Tumor Matter?. In: Journal of Urology. 2006 ; Vol. 176, No. 4. pp. 1292-1298.
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