Oligometastatic prostate cancer: a new horizon for robotic radical prostatectomy

The advent of modern diagnostic techniques and improved patient monitoring in the setting of clinical trials has led to an increased diagnosis of oligometastatic prostate cancer (OMPC), defined as three-to-five metastatic deposits in a single organ or multiple organs. OMPC is increasingly diagnosed in men who were in the past considered to have organ-confined disease. OMPC occurs at the transition between localized prostate cancer and widespread metastases. Our review evaluates the available evidence regarding robot-assisted cytoreductive prostatectomy feasibility and oncological outcomes in oligometastatic settings. We also consider the limitations and future directions for this approach. We performed a non-systematic PubMed and Google Scholar search. We screened pertinent studies published from 2014 up to May 2021. Our search identified 524 records. After excluding duplication, 54 full-text articles were identified and were screened for eligibility. We found nine papers (863 patients) that met the inclusion criteria for the review. The outcomes evaluated were 1-, 3-, and 5-year progression-free survival, cancer-specific and overall survival rates. Our review article demonstrates the feasibility and safety of Robot-assisted radical prostatectomy in patients with OMPC with proven oncological benefits. Prospective studies are ongoing and may provide further solid evidence.