AUA 2018: Quality of Life After Surgery for Localized Prostate Cancer
San Francisco, CA (UroToday.com) Both overall and cancer specific survival rates are very high for patients diagnosed and treated for clinically localized prostate cancer. Thus, complications, functional outcomes and health-related quality of life are important for patients and physicians making and guiding treatment choices in this scenario. In a moderated poster presented at the American Urologic Association Annual Meeting, Dr. McClain and colleagues report on the association between treatment modality and quality of life among a cohort of patients treated with robotic assisted laparoscopic radical prostatectomy, brachytherapy, and cryotherapy at a single institution.
AUA 2018: Adjuvant and Salvage Radiation Therapy After Radical Prostatectomy and the Impact on Long-Term Outcomes
San Francisco, CA (UroToday.com) For men with adverse pathologic features at the time of radical prostatectomy, the role of adjuvant as compared to salvage radiotherapy is hotly debated. While level 1 evidence has shown that adjuvant radiotherapy reduces biochemical recurrence, metastasis and possibly death when compared to a ‘wait and see’ approach, its merits compared to a salvage approach are currently still be evaluated. Using a large cohort of patients who underwent radical prostatectomy at three high volume urologic oncology centers in Europe and the United States, Dr. Bandini and colleagues presented a moderated poster at the American Urologic Association Annual Meeting describing trends in the use of adjuvant and salvage radiotherapy.
AUA 2018: Utilization of Salvage Radiation Therapy for Biochemical Recurrence After Radical Prostatectom
San Francisco, CA (UroToday.com) For men with adverse pathologic features at the time of radical prostatectomy, the role of adjuvant as compared to salvage radiotherapy is hotly debated. While level 1 evidence has shown that adjuvant radiotherapy reduces biochemical recurrence, metastasis and possibly death when compared to a ‘wait and see’ approach, its merits compared to a salvage approach are currently still be evaluated. In a a moderated poster at the American Urologic Association Annual Meeting using the statewide Michigan Urological Surgery Improvement Collaborative (MUSIC), Dr Hawken and colleagues assessed factors associated with the use of salvage radiotherapy (SRT) and the variation in the use of this approach.
AUA 2018: Oncologic Outcomes in Men with High Risk Prostate Cancer Eligible for Both Radical Prostatectomy and Radiotherapy: MD Anderson Multidisciplinary Clinic Experience
San Francisco, CA (UroToday.com) The optimal local therapy for patients with high risk prostate cancer remains an issue of considerable debate. Both radical prostatectomy and radiotherapy with concomitant androgen deprivation therapy are reasonable choices. In a moderated poster at the American Urologic Association Annual Meeting, Dr Reichard and colleagues present a comparative analysis of these two modalities based on the experience at the MD Anderson Cancer Center Multidisciplinary Clinic.
AUA 2018: Risk of Secondary Bladder Cancer After High Dose Rate Brachytherapy for Prostate Cancer
San Francisco, CA (UroToday.com) Treatment-induced secondary cancers are well described following radiotherapy for prostate cancer. While the majority of the literature has focused on external beam radiotherapy, the risk associated with brachytherapy appears to be somewhat less. To date, only the association between low dose rate brachytherapy and secondary cancers has been examined. However, high dose rate brachytherapy is increasingly being utilized. In a moderated poster at the American Urologic Association Annual Meeting, Dr Miyaji and colleagues from Kurashiki, Japan described their single center experience with secondary bladder cancers following high dose rate brachytherapy (HDR-BT), with or without external beam radiotherapy (EBRT).
AUA 2018: Impact of Perceived Ambiguity and Other Psychological Factors on Previous Prostate Cancer Screening Behavior Among 45-year-old Men: Findings from the PROBASE-Study
San Francisco, CA USA (UroToday.com) The German risk-adapted prostate cancer screening trial PROBASE is currently the largest ongoing screening trial and aims to accrue 50,000 men within 5 years in a prospective and randomized fashion. The trial opened in April 2014 and is powered for superiority in terms of specificity of risk-adapted PSA screening starting at age 50 as compared to 45 years with non-inferiority in terms of metastasis from prostate cancer. Men that are 45 years old are randomly assigned to risk-adapted screening beginning at age 45 or five years later at age 50. Both groups receive risk-adapted PSA screening based on baseline PSA values: < 1.5 ng/ml (low risk) – 5-yearly PSA (expected 90%), 1.5-2.99 ng/ml (intermediate risk) – 2-yearly PSA (expected 7.5%), ≥3.0 ng/ml (high risk) MRI and combined systematic and MRI/TRUS fusion-guided biopsy recommended.
AUA 2018: Negative MRI: Which Patients Could Safely Avoid Prostate Biopsy?
San Francisco, CA USA (UroToday.com) Over the last year, two impactful trials have propelled mpMRI into the spotlight for detection of prostate cancer [1,2]. The PROMIS trial subjected 576 men with a clinical suspicion of prostate cancer and no previous biopsy to mpMRI + TRUS biopsy, as well as a reference test (a template prostate mapping biopsy) . Clinically significant prostate cancer was Gleason ≥4+3 or a maximum cancer core length of ≥6 mm. On reference biopsy, 71% of men had cancer, with 40% of the 576 patients having clinically significant prostate cancer. Among patients with clinically significant cancer, mpMRI was more sensitive (93%, 95%CI 88-96%) than TRUS biopsy (48%, 95%CI 42-55%, p<0.0001). However, mpMRI was less specific (41%, 95%CI 36-46%) than TRUS biopsy (96%, 94-98%, p<0.0001).