A trial looking at surgery for men with prostate cancer that has spread to the bones (TRoMbone)

Cancer type:

Cancer spread to the bone

Prostate cancer

Secondary cancers

Status:

Results

Phase:

Other

This trial compared standard care to standard care with surgery. It was for men with prostate cancer that had spread to their bones. It was done to see if it would be possible to run a larger trial.

The trial was open for men to join between 2017 and 2018. The team published the results in 2022.

More about this trial

Doctors often treat prostate cancer that has spread to the bones with treatments such as hormone therapy.

Researchers think that having surgery to remove the prostate gland as well as other treatment may be useful. This operation is called a radical prostatectomy. They think this could help even though the cancer has spread.

To find this out, they need to do a large randomised clinical trial. This would compare standard treatment to standard treatment and surgery. First, they needed to do a smaller trial called a feasibility study.

The main aim of this trial was to find out if it would be possible to run a larger trial looking at surgery for men with prostate cancer that has spread.

Summary of results

Trial design
This trial was for men with prostate cancer that had spread to between 1 and 3 areas in their bones.

They were put into a treatment group at random:

half had standard treatment
half had standard treatment and surgery to remove their prostate

The research team interviewed some patients and health care professionals. This was to find out more about what they thought of the trial.

Results
The research team asked 71 men if they’d like to join the trial. And 51 agreed to join (72%). This is high enough to mean it should be possible to run a larger trial.

There were:

26 men in the standard care group
25 men in the standard care and surgery group

The research team interviewed 31 health care professionals and 15 patients. They asked them what they thought of the trial in more detail. They found out more about why some hospitals found it easier than others to find men to join the trial.

Side effects and quality of life
The men who had surgery to remove their prostate did have some side effects.

Men in both groups had difficulty getting an erection (erectile dysfunction) before they joined the trial. This was a bit worse afterwards for the men who had surgery.

No one taking part had problems with leaking urine (incontinence) before they joined the trial. Some men who had surgery did have incontinence after their operation. This affected:

nearly 4 out of 10 men (38%) a month after surgery
less than 2 out of 10 men (17%) 6 months after surgery

Three men who had surgery had an infection after their operation, but they all fully recovered.

The research team looked at whether having surgery affected quality of life. The results showed there was little difference between the 2 groups.

Conclusion
The research team concluded that it should be possible to run a larger trial looking at surgery and standard care for prostate cancer that has spread.

They recommend a larger randomised trial is done, to find out if surgery is a useful treatment for this group of men.

More detailed information
There is more information about this research in the reference below.

Please note, this article is not in plain English. It has been written for healthcare professionals and researchers.

Feasibility and safety of radical prostatectomy for oligo-metastatic prostate cancer: the Testing Radical prostatectomy in men with prostate cancer and oligo-Metastases to the bone (TRoMbone) trial
Prasanna Sooriakumaran and others
British Journal of Urology (BJU) International, 2022. Volume 130, Issue 1, Pages 43-53.

Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. We have not analysed the data ourselves.