AUA 2018: A Crossfire Debate: Controversies in Prostate Cancer (Pro) – Focal Ablation of Oligometastatic Prostate Cancer

San Francisco, CA ( The management of patients with oligometastatic prostate cancer remains a controversial topic in urology.  The crossfire debate at the 2018 American Urologic Association’s Annual meeting discussed the role of focal ablation of oligometastatic disease as opposed to using systemic androgen deprivation therapy (ADT) with the additional of abiraterone.  The participants of the debate who took the pro side of the session argued that there is emerging data that focal ablation of oligometastatic disease is beneficial for patients. 

AUA 2018: Duration of PSA Surveillance after Radical Prostatectomy: A Risk Adapted Approach  

San Francisco, CA ( How long do we check PSA levels after a patient undergoes a radical prostatectomy? With patients living longer than ever after definitive local therapy for prostate cancer, this is an important clinical question. In fact, a literature search revealed little/no definitive timeline to when we may safely refrain from continuing to check PSA after radical prostatectomy.  In clinical practice, most urologists will typically check a PSA once a year, whereas some will decrease this to every two years after a period of undetectable PSA. 

AUA 2018: Should Gleason Score at the Positive Surgical Margin appear on the Pathology Report for Robot-Assisted Radical Prostatectomy? 

San Francisco, CA ( Dr. Kanao and colleagues from Japan presented their group’s argument that Gleason score at the surgical margin should be reported on pathology reports after robotic radical prostatectomy at the prostate cancer surgical therapy session. Given the heterogeneity of prostate cancer, clinical situations may include (i) an index tumor of Gleason 4+4 disease with negative margins, or (ii) a Gleason 3+3 disease prostate with a positive surgical margin. The group from the John Hopkins’ James Buchanan Brady Urologic Institute recently reported the impact of a Gleason score at the surgical margin among 4,082 patients undergoing radical prostatectomy and pelvic lymph node dissection [1].

AUA 2018: Establishment of the Optimal Follow-Up Schedule After Radical Prostatectomy

San Francisco, CA ( Kazuhiro Matsumoto, MD and colleagues from Tokyo, Japan discussed their team’s assessment of the optimal schedule for PSA follow-up after radical prostatectomy. PSA follow-up after treatment allows clinicians to identify patients early for those that may benefit from salvage therapy after biochemical recurrence. This is important considering that metastasis is typically detected a median 8 years after the elevation of PSA, and a median time to death after the development of metastatic disease is just less than 5 years [1].

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