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

In brief

Robot-assisted prostatectomy with ADT reduces progression and death by ~75%

In a retrospective multicenter analysis of 290 oligometastatic prostate cancer patients, adding robot-assisted radical prostatectomy to androgen deprivation therapy lowered the risk of radiographic progression and overall mortality by roughly three-quarters compared with ADT alone. The benefit persisted across subgroups, but the modest sample size warrants prospective confirmation.

Journal
Urologic oncology (Q1)
Published
22 September 2026
Study design
Cohort / observational study
Evidence level
Level 3, Low (CEBM 3b)
Authors
Yujie Dong, Zhen Tian, Weilin Chen, Zhuoran Li, Zhiqiang Chen, Jieping Hu, et al.
PMID
42772021
DOI
10.1016/j.urolonc.2026.08.025

Why clinicians should know about it

  • Picked for Surgical Oncology (paper of the day, 27 September 2026): RARP + ADT improves OmPCa outcomes

Abstract

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.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.