Association of robot-assisted radical prostatectomy with improved oncological outcomes in patients with oligometastatic prostate cancer: A multicenter exploratory study in China.

Objective

To evaluate the efficacy of robot-assisted radical prostatectomy (RARP) combined with androgen deprivation therapy (ADT) vs. ADT alone on oncological outcomes in oligometastatic prostate cancer (OmPCa) patients.

Methods

This multicenter retrospective analysis included 290 patients with OmPCa who received RARP combined with ADT (n = 170) or ADT alone (n = 120) at 5 Chinese medical centers between December 2008 and December 2023. Inverse probability of treatment weighting was applied to control for confounding factors. Radiographic progression-free survival (rPFS) and overall survival (OS) were used as clinical endpoints to evaluate the impact of RARP combined with ADT on oncological outcomes in patients with OmPCa.

Results

After IPTW adjustment, baseline characteristics were well balanced between the 2 groups (all SMD < 0.10). Compared with the non-surgical group, the surgical group had significantly prolonged median rPFS (hazard ratio = 0.24, 95% confidence interval: 0.17-0.33, P < 0.001) and median OS (hazard ratio = 0.22, 95% confidence interval: 0.14-0.33, P < 0.001). Time-varying covariate analysis also supported this finding (both P < 0.001). Exploratory subgroup analyses indicated that, regardless of baseline characteristics, patients in the surgical group had significantly prolonged rPFS and OS (all P < 0.05).

Conclusion

RARP combined with ADT was significantly associated with improved oncological outcomes in patients with OmPCa, and this association was independent of baseline characteristics; however, this finding is limited by the relatively small sample size and requires validation in prospective studies.