SIU 2017: ProtecT, PIVOT and SPCG-4: Placing New Evidence into Context
Lisbon, Portugal (UroToday.com) Dr. Wilt began his presentation with an overview of the PIVOT trial. This trial assessed whether among men with localized prostate cancer does the intent to treat with radical prostatectomy reduce all cause and prostate cancer mortality compared to observation.
SIU 2017: Evidence-Based Outcomes in Oncology: Implications for Patient Care
Lisbon, Portugal (UroToday.com) Dr. Mottet gave an overview of prospective trials analyzing observation vs. treatment in prostate cancer. The SPCG 4 trial showed a clear benefit to surgery with a relative risk of 0.75 (CI 95% 0.61-0.92) and 0.62 (95% CI 0.44-0.87) in overall death and prostate cancer specific death, respectively.
However, the PIVOT trial showed no survival benefit at all between observation and surgery.
SIU 2017: ProtecT in 2017: What Have We Learnt?
Lisbon, Portugal (UroToday.com) Dr. James Catto gave an excellent overview of the ProtecT study. This study is a major PSA testing and 3 arm randomized trial of treatment effectiveness in prostate cancer. It compared between active monitoring (AM) vs. surgery vs. radiotherapy. The primary endpoint was prostate cancer specific survival at 10 years. It also analyzed all cause death, cancer progression and metastasis, and patient reported outcomes.
SIU 2017: MRI As a Triage Test in Prostate Cancer Diagnostic Algorithm in Biopsy - Naïve Men: A Prospective Study
Lisbon, Portugal (UroToday.com) With the use of mpMRI increasing, there is growing enthusiasm to utilize it in other spaces within the management of prostate cancer. At this time, it is currently approved and recommended for patients with prior negative TRUS systematic biopsy for an elevated PSA, patients on AS prior to repeat biopsy, or in local staging purposes prior to definitive therapy. However, it has not yet been proven to be effective as part of the diagnostic workup prior to initial biopsy.
SIU 2017: Economic Effectiveness of Urinary PCA3 Test in Cases of Serum PSA Level 4-10 Ng/Ml
Lisbon, Portugal (UroToday.com) In this study, the authors assess the cost effectiveness of the urinary PCA3 test in patients with serum PSA between 4-10 ng/mL. Of note, the utility of the PCA3 test is in differentiating cancer from inflammation, not specifically high-risk cancer.
SIU 2017: Atypical Small Acinar Proliferation: Progression to Clinically Significant Prostate Cancer?
Lisbon, Portugal (UroToday.com) Guideline recommendation for atypical small acinar proliferation (ASAP) diagnosed on prostate biopsy recommends repeat biopsy within 3-6 months after initial diagnosis. The authors attempted to discern the rate of detecting clinically significant prostate cancer on subsequent biopsy as well as any predictors associated with progression using the 5 tier Gleason grade grouping system (GGGS).
SIU 2017: Biojet – Real Time TRUS/MRI Fusion Biopsy of The Prostate: Value of Combining Targeted and Systematic Biopsies
Lisbon, Portugal (UroToday.com) This retrospective study was conducted to evaluate the performance of perineal Biojet (DK-Medical) magnetic resonance (MR)-ultrasound-guided fusion biopsy in diagnosing prostate cancer (PCa).