ASCO GU 2018: Case-Based Debate: Magnetic Resonance and Magnetic Resonance-Directed Biopsy: Where is the Field Moving?
San Francisco, CA (UroToday.com) In this opening session of the Genitourinary Cancers Symposium 2018, Drs. Emberton and Pedrosa shared their data and experiences with MR and MR directed biopsy in evaluation of prostate cancers. Three patient scenarios were then discussed with the panel. The current AUA and SAR standard strongly considers MRI for a patient with continuing concern for prostate cancer and a previous negative biopsy. However, the method of MR directed biopsy is under debate.
ASCO GU 2018: Adjuvant Radiotherapy and Chemotherapy in Node-Positive Prostate Cancer
San Francisco, CA (UroToday.com) The use adjuvant treatment for patients with high risk or node-positive prostate cancer patients remains controversial despite level 1 evidence demonstrating a benefit. The controversy revolves around the risk of overtreatment in addition to the lack of evidence demonstrating the superiority of adjuvant over early salvage therapy.
ASCO GU 2018: Ten-year final results of the TROG 03.04 (RADAR) randomized phase-III trial
San Francisco, CA (UroToday.com) Historical data from RTOG 92.02 and EORTC 22961 have shown that long-term androgen deprivation therapy (ADT) is more effective than short-term ADT in men undergoing radiotherapy for clinically localized intermediate or high risk prostate cancer. However, long-term ADT carries with it a range of side-effects including sexual dysfunction, weight gain, bone density loss, cognitive dysfunction, and sarcopenia, to name a few.
ASCO GU 2018: Newly Diagnosed High-Risk Disease Treatment: Summarizing Neoadjuvant Trials
San Francisco, CA (UroToday.com) There are approximately 60,000 cases of clinically localized, high risk prostate cancer in the United States yearly. This number may increase in the future, as prostate cancer screening has declined in recent years. Men with high risk disease have a Gleason score of 8-10, a PSA of >20, or pT3 disease. Despite treatment, men with high risk disease have a significant risk of death from prostate cancer, with one study showing a rate of 31% at 15 to 20 years.