Therapeutic Effect of Cytoreductive Radical Prostatectomy in Men With Newly Diagnosed Metastatic Prostate Cancer

Prior treatment

• Received ADT for more than 6 months prior to consent
• Life expectancy of less than 6 months prior to consent
• Deep vein thrombosis (DVT) / pulmonary embolism (PE) in the past 6 months prior to consent
• Previous local therapy for prostate cancer
• Patients who have chemotherapy or radiotherapy for non-prostate cancer related treatment within 3 weeks prior to consent

Other illness

• Deemed to have unresectable disease by surgeon

Other

• Refuses to give informed consent
• Active spinal cord compression

• Histologically proven adenocarcinoma of the prostate
• Evidence of metastasis by magnetic resonance imaging (MRI)/computed tomography (CT) scan, bone scan, or histologic confirmation
• Clinical stage M1a (distant lymph node positive), M1b (bone metastasis), or M1c (solid organ metastasis.
• If solitary lesion, metastasis confirmed with either biopsy or two independent imaging modalities (i.e. CT and PET \[positron emission tomography\], bone scan and MRI, modality at the discretion of the treating physician)
• No previous local therapy for prostate cancer (i.e prostate radiation, cryotherapy, etc.)
• Give informed consent
• Prostate deemed resectable by surgeon
• Plans to start or has already started ADT no longer than 6 months prior to consent.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Hemoglobin (HgB) \>= 9 g/dL compatible for surgery
• Platelets \> 80,000/mcL compatible for surgery
• Aspartate aminotransferase (AST) =\< 2x upper limit of normal (ULN) compatible for surgery
• Alanine aminotransferase (ALT) =\< 2x upper limit of normal (ULN) compatible for surgery