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Prostate

Prostate knowledge base with publications, presentations, videos and more.


  • Radical prostatectomy or watchful waiting in early prostate cancer.

    Bill-Axelson A. Holmberg L. Garmo H. Rider J.R. Taari K. Busch C. Nordling S. Haggman M. Andersson S.-O. Spangberg A. Andren O. Palmgren J. Steineck G. Adami H.-O. Johansson J.-E.

    Comment by Henk van der Poel:
    In clinical prostate cancer prostatectomy was shown to improve survival also at longer follow up with an absolute risk reduction in death from prostate cancer of 11% and a number needed to treat to prevent one prostate cancer death of 8. Younger men and men with intermediate risk prostate cancer were most likely to benefit. Interestingly, prostatectomy did reduce the risk of metastases in older men. For men treated with watchful-waiting the risk of dying at 18 years was 68.9% versus 56.1% for the prostatectomy treated men. This all comes with a price: earlier data show an almost 4x higher risk of urinary leakage in the prostatectomy group, with surprisingly, comparable erectile dysfunction rates for both arms. Is 18 years long enough. Certainly for men under 65 years of age longer follow up is warranted, in particular considering the risk of metastases in the prostatectomy arm of 26.1% at 18 years.
  • Can we deliver randomized trials of focal therapy in prostate cancer?

    Ahmed H.U. Berge V. Bottomley D. Cross W. Heer R. Kaplan R. Leslie T. Parker C. Relton C. Stephens R. Sydes M.R. Turnbull L. van der Meulen J. Vickers A. Wilt T. Emberton M.

    Comment by Henk van der Poel:
    Focal therapy: from “male lumpectomy” to proven standard therapy seems a long way. So far no convincing large randomized studies have defined the place of focal therapy in localized prostate cancer management. One third of men with low grade prostate cancer will harbor higher grade disease. Active surveillance programs show clinical progression defined by several criteria to occur in up to 40% of men in the early years of management. Ahmed and Emberton in Nat Rev Clin Oncology suggest a clinical trial comparing focal therapy against whole gland surgery or radiotherapy. A randomized trial comparing focal hemiablation of the prostate applying vascular targeted photodynamic therapy using WST011 against active surveillance has completed accrual and 2 year biopsy follow up data are expected in 2015.
  • Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer: observational study of mortality outcomes

    Prasanna Sooriakumaran, Tommy Nyberg, Olof Akre, Leif Haendler, Inge Heus, Mats Olsson, Stefan Carlsson, Monique J Roobol, Gunnar Steineck, Peter Wiklund

    Comment by Henk van der Poel:
    Does patient selection explain observed better outcome after surgery than radiotherapy? Non-prostate mortality higher after external beam radiotherapy than prostatectomy. No difference in survival after radiotherapy or surgery in metastasized prostate cancer. Still no proof of inequality.
  • Mortality and complications after prostate biopsy in the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial

    Paul F. Pinsky, Howard L. Parnes, Gerald Andriole

    Comment by Henk van der Poel:
    Less than 1% infectious complications after prostate biopsies in the PLCO-study.  A larger prostate, earlier infections and black race predict increased risk of infectious complications.
  • Formation of the Stoma

    by M. Annersted

    Tag:
  • Accuracy of Multiparametric MRI for Prostate Cancer Detection: A Meta-Analysis

    de Rooij M, Hamoen EH, Fütterer JJ, Barentsz JO, Rovers MM.

    Comment by Henk van der Poel:
    Meta-analysis of MRI performance:  sensitivity of prostate cancer detection by MRI: 74% and specificity of 88%.  Therefore: negative MRI does not excluded cancer.
  • Coffee consumption and risk of prostate cancer: a meta-analysis of prospective cohort studies

    Xiaofeng Yu, Zhijun Bao, Jian Zou, Jie Dong

    Comment by Henk van der Poel:
    Coffee consumption decreases the risk of PCA by 12%.
  • Abiraterone acetate plus prednisone versus prednisone alone in chemotherapy-naive men with metastatic castration-resistant prostate cancer: patient-reported outcome results of a randomised phase 3 trial

    Ethan Basch, Karen Autio, Charles J Ryan, Peter Mulders, Neal Shore, Thian Kheoh, Karim Fizazi, Christopher J Logothetis, Dana Rathkopf, Matthew R Smith, Paul N Mainwaring, Yanni Hao, Thomas Griffin, Susan Li, Michael L Meyers, Arturo Molina, Charles Clee

    Comment by Henk van der Poel:
    Abiraterone preserves QOL better than docetaxel. Abiraterone and prednisone delays QOL deterioration by more than 6 months. That is at least comparable to changes in QOL with docetaxel in the TAX327 at a lower toxicity rate for abiraterone.

     

     

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Prostate Cancer News from ASCO 2014

Commentaries from Susanne Osanto on a selection of presentations within Prostate Cancer from this year’s ASCO meeting.


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