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Wagaskar et al. Mini-invasive Surg 2022;6:14  https://dx.doi.org/10.20517/2574-1225.2021.106  Page 5 of 8



 Table 1. Summary of studies using CRP for OMPC

 OMPC criteria                                   Functional
 Authors  Study type  n  PFS  CSS  OS                             SRC (details)
 (DM)                                            outcome
 [7]
 Heidenreich et al.    Retrospective  ≤ 3 Bone (CT, SS) 104 (O-CRP)   NR  89% at 3 years; 81% at  80% at 5 years  68% UC at 12   9% (5% - RL for bleeding; 4%-
 (2018)  9 (RA-CRP)  5 years                     months           LD)
 [11]
 Sooriakumaran et al.    Retrospective  M1a-M1b   106 (O-CRP)  NR  NR  89% at 23 months  64% UC at 3   19% (14%-BT; 5%-LD)
 (2016)  (CT, SS)                                months
 [12]
 Jang et al.   (2018)  Retrospective  ≤ 5 Bone (SS)  38 (RA-CRP)   75% (RA-CRP) vs. 40%   NR  NR  NR  13% (8%-BT; 5%-RL for rectal
 41 (NLT)  (NLT) at 40 months                                     injury; bleeding)
 [13]
 Culp et al.   (2014)  Population   M1a-M1c (NR)  245 (O-CRP)   NR  76% (RP) vs. 61%   67% (RP) vs. 53%   NR  NR
 based  7811 (nCRP)  (nCRP) at 5 years  (nCRP) at 5 years
 [17]
 Antwi and Everson     Population   M1a-M1c (SS)  222 (O-CRP)  NR  85%  82%  NR  NR
 (2014)  based
 [16]
 Gratzke et al.   (2014) Population   M1 (SS)  74 (O-CRP)   NR  NR  55% (RP) vs. 21%   NR  NR
 based  7811 (NLT)         (NLT) at 5 years
 [15]
 Satkunasivam et al.     Population   M1 (CT, SS)  47 (O-CRP)  NR  79% at 3 years  73% at 3 years  NR  NR
 (2015)  based
 [14]
 Gandaglia et al.     Retrospective  ≤ 5 Bone   11 (RA-CRP)  NR  82% at 7 years  NR  NR  82% (73%-BT, 9%-RL for
 (2016)  (CT/MRI, SS)                                             anastomotic leakage)
 [18]
 Poelaert et al.   (2017) Prospective  < 4 Bone (SS)  1 (O-CRP)   NR  100% (RP) vs. 61%   100% (RP) vs. 51%   49% UC at 3   0%
 15 (RA-CRP)   (NLT) at 2 years  (NLT) at 2 years  months
 9 (NLT)

 CRP: Cytoreductive radical prostatectomy; OMPC: oligometastatic prostate cancer; DM: diagnostic method; PFS: progression-free survival; CSS: cancer-specific survival; OS: overall survival; SRC: surgery-related
 complications; CT: computed tomography; SS: skeletal scintigraphy; MRI: magnetic resonance imaging; O-CRP: open cytoreductive radical prostatectomy; RA-CRP: robot-assisted cytoreductive radical
 prostatectomy; UC: urinary continence (defined as 0-1 pads per day); NLT: no local therapy; NR: not reported; RL: repeat laparotomy; LD: lymphocele drainage; BT: blood transfusion.



 prostatectomy in OMPC settings; and (3) an emerging role for robot-assisted cytoreductive prostatectomy in selected men with OMPC.



 Men diagnosed with metastatic prostate cancer usually receive systemic therapy, such as androgen deprivation therapy and chemotherapy, while radical

 prostatectomy is typically reserved for localized prostate cancers. However, Tzelepi et al.  demonstrated the intra-prostatic survival of lethal prostate cancer
             [21]
 cell clones with the biological potential to metastasize despite systemic therapy. A growing body of evidence suggests that control of a primary tumor may

 delay the progress of metastases, thereby improving overall survival and reducing prostate cancer-specific mortality. Recently systematic review and meta-
 analysis were conducted that compared CRP to systemic and radiation therapy in the treatment of OMPC. This systematic review showed that CRP had
         [22]
 significantly higher 1-, 3-, and 5-year CSS and OS rates compared to systemic therapy . This review of the current literature also demonstrated that men with
 OMPC experience improved PFS, OS, and CSS after CRP.
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