Short-term clinical outcomes of cytoreductive radical prostatectomy combined with abiraterone-based androgen deprivation therapy in oligometastatic prostate cancer

This retrospective cohort study evaluated the clinical value and short-term prognostic outcomes of cytoreductive radical prostatectomy using the cytoreductive radical prostatectomy (CRP) technique combined with pharmacotherapy in patients with oligometastatic prostate cancer (OPC). Consecutive OPC patients treated between January 2023 and December 2023 were included. According to the actual treatment received, patients were assigned to a pharmacotherapy group (control) or a CRP technique plus pharmacotherapy group (study), with 47 patients in each group. All patients were followed for 24 months. Baseline demographics and clinical variables were compared between groups. Treatment response was assessed using Prostate Cancer Working Group 3 criteria. Serum prostate-specific antigen levels were recorded at baseline and at 2, 6, and 12 months. Quality of life, pain, and anxiety were evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, visual analog scale, and generalized anxiety disorder-7, respectively. Complications were graded by the Clavien-Dindo classification. Survival outcomes were analyzed using Kaplan-Meier methods. Baseline characteristics were comparable between groups. The CRP combined with intensified systemic therapy showed a higher proportion of complete/partial response and a lower proportion of progression than the pharmacotherapy group. Between-group differences in prostate-specific antigen were evident at the 2-month assessment. Posttreatment European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 scores were higher, whereas visual analog scale and generalized anxiety disorder-7 scores were lower, in the combined-treatment group. Complications were infrequent and limited to grade I events, with no between-group difference. No deaths occurred during follow-up; progression-free survival was longer in the combined-treatment group. Cytoreductive radical prostatectomy using the CRP technique combined with pharmacotherapy was associated with improved short-term disease control and progression-free survival without an apparent increase in complications in OPC.