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

Inclusion Criteria:

• 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 independentimaging modalities (i.e. CT and PET [positron emission tomography], bone scan andMRI, 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 antiandrogen therapy (ADT) no longer than 6months 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 forsurgery

• Alanine aminotransferase (ALT) =< 2x upper limit of normal (ULN) compatible forsurgery

Exclusion Criteria:

• Refuses to give informed consent

• Deemed to have unresectable disease by surgeon

• Received ADT for more than 6 months prior to consent

• Life expectancy of less than 6 months prior to consent

• Active spinal cord compression

• Deep vein thrombosis (DVT) / pulmonary embolism (PE) in the past 6 months prior toconsent

• Previous local therapy for prostate cancer

• Patients who have chemotherapy or radiotherapy for non-prostate cancer relatedtreatment within 3 weeks prior to consent