Skip to main content

Advertisement

SpringerLink
Log in

Local and systemic therapy for patients with metastatic prostate cancer: should the primary tumor be treated?

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Data from well-designed, prospective clinical trials are lacking to support treatment of primary tumor in men diagnosed with metastatic prostate cancer. However, a growing body of evidence suggests that treatment of the primary tumor may enhance cancer control and survival in some men. This evidence is examined and recommendations are made for identifying patients with metastatic prostate cancer who may benefit from definitive treatment of the prostate tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. National Cancer Institute Clinical Trials Search Results. www.cancer.gov. Accessed February 14, 2004.

  2. Anonymous: The National Institutes of Health Consensus Development Conference: Adjuvant Therapy for Breast Cancer. Bethesda, MD: November 1–3, 2000. J Natl Cancer Inst Monogr 2001, 30:1–152.

  3. Gill S, Loprinzi CL, Sargent DJ, et al.: Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: Who benefits and by how much? J Clin Oncol 2004, 22:1797–1806.

    Article  PubMed  CAS  Google Scholar 

  4. Gunderson LL, Sargent DJ, Tepper JE, et al.: Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis. J Clin Oncol 2004, 22:1785–1796.

    Article  PubMed  Google Scholar 

  5. Jemal A, Murray T, Ward E, et al.: Cancer statistics, 2005. CA Cancer J Clin 2005, 55:10–30.

    Article  PubMed  Google Scholar 

  6. Lu-Yao G, Stukel TA, Yao SL: Changing patterns in competing causes of death in men with prostate cancer: a populationbased study. J Urol 2004, 171:2285–2290.

    Article  PubMed  Google Scholar 

  7. Paquette EL, Sun L, Paquette LR, et al.: Improved prostate cancerspecific survival and other disease parameters: impact of prostate-specific antigen testing. Urology 2002, 60:756–759.

    Article  PubMed  Google Scholar 

  8. Partin AW, Mangold LA, Lamm DM, et al.: Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology 2001, 58:843–848.

    Article  PubMed  CAS  Google Scholar 

  9. Kattan MW, Zelefsky MJ, Kupelian PA, et al.: Pretreatment nomogram that predicts 5-year probability of metastasis following three-dimensional conformal radiation therapy for localized prostate cancer. J Clin Oncol 2003, 21:4568–4571.

    Article  PubMed  Google Scholar 

  10. Crook JM, Choan E, Perry GA, et al.: Serum prostate-specific antigen profile following radiotherapy for prostate cancer: implications for patterns of failure and definition of cure. Urology 1998, 51:566–572.

    Article  PubMed  CAS  Google Scholar 

  11. Crook JM, Bahadur YA, Bociek RG, et al.: Radiotherapy for localized prostate carcinoma: the correlation of pretreatment prostate-specific antigen and nadir prostate-specific antigen with outcome as assessed by systematic biopsy and serum prostate specific antigen. Cancer 1997, 79:328–336.

    Article  PubMed  CAS  Google Scholar 

  12. Battermann JJ, Boon TA, Moerland MA: Results of permanent prostate brachytherapy: 13 years of experience at a single institution. Radiother Oncol 2004, 71:23–28.

    Article  PubMed  Google Scholar 

  13. Dinges S, Deger S, Koswig S, et al.: High-dose rate interstitial with external beam irradiation for localized prostate cancer: results of a prospective trial. Radiother Oncol 1998, 48:197–202.

    Article  PubMed  CAS  Google Scholar 

  14. Frohmuller HG, Theiss M, Manseck A, Wirth MP: Survival and quality of life of patients with stage D1 (T1-3 pN1-2 M0) prostate cancer: radical prostatectomy plus androgen deprivation versus androgen deprivation alone. Eur Urol 1995, 27:202–206.

    PubMed  CAS  Google Scholar 

  15. Steinberg GD, Epstein JI, Piantadosi S, Walsh PC: Management of stage D1 adenocarcinoma of the prostate: the Johns Hopkins experience 1974 to 1987. J Urol 1990, 144:1425–1432.

    PubMed  CAS  Google Scholar 

  16. Robnett TJ, Whittington R, Malkowicz SB, et al.: Long-term use of combined radiation therapy and hormonal therapy in the management of stage D1 prostate cancer. Int J Radiat Oncol Biol Phys 2002, 53:1146–1151.

    Article  PubMed  Google Scholar 

  17. Sanguineti G, Marcenaro M, Franzone P, et al.: Is there a “curative” role of radiotherapy for clinically localized hormone refractory prostate cancer? Am J Clin Oncol 2004, 27:264–268.

    Article  PubMed  Google Scholar 

  18. Akimoto T, Kitamoto Y, Saito J, et al.: External beam radiotherapy for clinically node-negative, localized hormone-refractory prostate cancer: impact of pretreatment PSA value on radiotherapeutic outcomes. Int J Radiat Oncol Biol Phys 2004, 59:372–379.

    Article  PubMed  Google Scholar 

  19. Hernes E, Fossa SD, Skovlund E: Androgen-independent prostate cancer: the clinical problem of a growing pelvic tumour. Acta Oncologica 2003, 42:749–755.

    Article  PubMed  Google Scholar 

  20. Pilepich MV, Winter K, John MJ, et al.: Phase-III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001, 50:1243–1252.

    Article  PubMed  CAS  Google Scholar 

  21. Lawton CA, Winter K, Murray K, et al.: Updated results of the phase-III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001, 49:937–946.

    Article  PubMed  CAS  Google Scholar 

  22. Cox RL, Crawford ED: Complications of cryosurgical ablation of the prostate to treat localized adenocarcinoma of the prostate. Urology 1995, 45:932–935.

    Article  PubMed  CAS  Google Scholar 

  23. Touma NJ, Izawa JI, Chin JL: Current status of local salvage therapies following radiation failure for prostate cancer. J Urol 2005, 173:373–379.

    Article  PubMed  Google Scholar 

  24. Anastasiadis AG, Sachdev R, Salomon L, et al.: Comparison of health-related quality of life and prostate-associated symptoms after primary and salvage cryotherapy for prostate cancer. J Cancer Res Clin Oncol 2003, 129:676–682.

    Article  PubMed  Google Scholar 

  25. Ghafar MA, Johnson CW, De La Taille A, et al.: Salvage cryotherapy using an argon-based system for locally recurrent prostate cancer after radiation therapy: the Columbia experience. J Urol 2001, 166:1333–1338.

    Article  PubMed  CAS  Google Scholar 

  26. de la Taille A, Hayek O, Benson MC, et al.: Salvage cryotherapy for recurrent prostate cancer after radiation therapy: the Columbia experience. Urology 2000, 55:79–84.

    Article  PubMed  Google Scholar 

  27. Izawa JI, Perrotte P, Greene GF, et al.: Local tumor control with salvage cryotherapy for locally recurrent prostate cancer after external beam radiotherapy. J Urol 2001, 165:867–870.

    Article  PubMed  CAS  Google Scholar 

  28. GhavamianR, Bergstralh EJ, Blute ML, et al.: Radical retropubic prostatectomy plus orchiectomy versus orchiectomy alone for pTxN+ prostate cancer: a matched comparison. J Urol 1999, 161:1223–1228. Series of men with node-positive prostate cancer demonstrating improved cancer control and survival with combined local and systemic treatment.

    Article  PubMed  CAS  Google Scholar 

  29. Coen JJ, Zietman AL, Thakral H, Shipley WU: Radical radiation for localized prostate cancer: local persistence of disease results in a late wave of metastases. J Clin Oncol 2002, 20:3199–3205.

    Article  PubMed  Google Scholar 

  30. Roach M 3rd, DeSilvio M, Lawton C, et al.: Phase-III trial comparing whole-pelvic versus prostate-only radiotherapy and neoadjuvant versus adjuvant combined androgen suppression: Radiation Therapy Oncology Group 9413. J Clin Oncol 2003, 21:1904–1911.

    Article  PubMed  Google Scholar 

  31. Roudier MP, True LD, Higano CS, et al.: Phenotypic heterogeneity of end-stage prostate carcinoma metastatic to bone. Hum Pathol 2003, 34:646–653.

    Article  PubMed  Google Scholar 

  32. Klein CA, Blankenstein TJ, Schmidt-Kittler O, et al.: Genetic heterogeneity of single disseminated tumour cells in minimal residual cancer. Lancet 2002, 360:683–689.

    Article  PubMed  CAS  Google Scholar 

  33. Cheng L, Slezak J, Bergstralh EJ, et al.: Dedifferentiation in the metastatic progression of prostate carcinoma. Cancer 1999, 86:657–663.

    Article  PubMed  CAS  Google Scholar 

  34. Seay TM, Blute ML, Zincke H: Long-term outcome in patients with pTxN+ adenocarcinoma of prostate treated with radical prostatectomy and early androgen ablation. J Urol 1998, 159:357–364. Describes a large series with long-term follow-up of men with node-positive prostate cancer managed with prostatectomy and early androgen deprivation.

    Article  PubMed  CAS  Google Scholar 

  35. Zagars GK, Pollack A, von Eschenbach AC: Addition of radiation therapy to androgen ablation improves outcome for subclinically node-positive prostate cancer. Urology 2001, 58:233–239.

    Article  PubMed  CAS  Google Scholar 

  36. Thompson IM, Tangen C, Basler J, Crawford ED: Impact of previous local treatment for prostate cancer on subsequent metastatic disease. J Urol 2002, 168:1008–1012.

    Article  PubMed  Google Scholar 

  37. Flanigan RC, Salmon SE, Blumenstein BA, et al.: Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 2001, 345:1655–1659.

    Article  PubMed  CAS  Google Scholar 

  38. Mickisch GH, Garin A, van Poppel H, et al.: Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet 2001, 358:966–970.

    Article  PubMed  CAS  Google Scholar 

  39. Thigpen T: The if and when of surgical debulking for ovarian carcinoma. N Engl J Med 2004, 351:2544–2546.

    Article  PubMed  CAS  Google Scholar 

  40. Eisenkop SM, Spirtos NM, Friedman RL, et al.: Relative influences of tumor volume before surgery and the cytoreductive outcome on survival for patients with advanced ovarian cancer: a prospective study. Gynecol Oncol 2003, 90:390–396.

    Article  PubMed  Google Scholar 

  41. Petrylak DP, Tangen CM, Hussain MH, et al.: Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 2004, 351:1513–1520.

    Article  PubMed  CAS  Google Scholar 

  42. Tannock IF, de Wit R, Berry WR, et al.: Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 2004, 351:1502–1512.

    Article  PubMed  CAS  Google Scholar 

  43. Wei JT, Dunn RL, Sandler HM, et al.: Comprehensive comparison of health-related quality of life after contemporary therapies for localized prostate cancer. J Clin Oncol 2002, 20:557–566.

    Article  PubMed  Google Scholar 

  44. Sgrignoli AR, Walsh PC, Steinberg GD, et al.: Prognostic factors in men with stage D1 prostate cancer: identification of patients less likely to have prolonged survival after radical prostatectomy. J Urol 1994, 152:1077–1081.

    PubMed  CAS  Google Scholar 

  45. Palapattu GS, Allaf ME, Trock BJ, et al.: Prostate-specific antigen progression in men with lymph node metastases following radical prostatectomy: results of long-term follow-up. J Urol 2004, 172:1860–1864. Large series of men with node-positive prostate cancer treated with radical prostatectomy followed by observation, with long-term follow-up.

    Article  PubMed  Google Scholar 

  46. Eisenberger MA, Blumenstein BA, Crawford ED, et al.: Bilateral orchiectomy with or without flutamide for metastatic prostate cancer. N Engl J Med 1998, 339:1036–1042.

    Article  PubMed  CAS  Google Scholar 

  47. Tangen CM, Faulkner JR, Crawford ED, et al.: Ten-year survival in patients with metastatic prostate cancer. Clin Prostate Cancer 2003, 2:41–45.

    PubMed  Google Scholar 

  48. Singh D, Yi WS, Brasacchio RA, et al.: Is there a favorable subset of patients with prostate cancer who develop oligometastases? Int J Radiat Oncol Biol Phys 2004, 58:3–10.

    Article  PubMed  Google Scholar 

  49. Yamashita K, Denno K, Ueda T, et al.: Prognostic significance of bone metastases in patients with metastatic prostate cancer. Cancer 1993, 71:1297–1302.

    Article  PubMed  CAS  Google Scholar 

  50. Cochrane AL: Effectiveness and Efficiency: Random Reflections on Health Services. Abingdon: Nuffield Provincial Hospitals Trust; 1971.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Texas Health Sciences Center, 7703 Floyd Curl Drive, 78229, San Antonio, TX, USA

    Edith D. Canby-Hagino MD

Authors
  1. Edith D. Canby-Hagino MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory P. Swanson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. David Crawford MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joseph W. Basler PhD, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Javier Hernandez MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ian M. Thompson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Canby-Hagino, E.D., Swanson, G.P., Crawford, E.D. et al. Local and systemic therapy for patients with metastatic prostate cancer: should the primary tumor be treated?. Curr Urol Rep 6, 183–189 (2005). https://doi.org/10.1007/s11934-005-0006-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-005-0006-5

Keywords

Search

Navigation