Local-regional prostate cancer

Abstract Historically, locally advanced prostate cancer was defined clinically with the digital rectal exam (DRE). With the introduction of screening prostate specific antigen (PSA), further pretreatment stratification of locally advanced prostate cancer was possible. Tables and nomograms have been...

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Bibliographic Details
Published in:Urologic oncology 2008-09, Vol.26 (5), p.516-521
Main Authors: Jones, Marklyn J., M.D, Koeneman, Kenneth S., M.D
Format: Article
Language:English
Subjects:
Clinical Trials as Topic
Digital Rectal Examination
Humans
Locally advanced
Male
Neoplasm Staging - methods
Prostate adenocarcinoma
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood
Prostatic Neoplasms - pathology
Prostatic Neoplasms - therapy
Risk
Staging
Urology
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Summary:Abstract Historically, locally advanced prostate cancer was defined clinically with the digital rectal exam (DRE). With the introduction of screening prostate specific antigen (PSA), further pretreatment stratification of locally advanced prostate cancer was possible. Tables and nomograms have been developed to predict pathologic staging prior to therapy. By combining DRE, PSA, Gleason score, and clinical staging, a patient's probability of treatment failure is estimated, thereby stratifying the risk of locally advanced disease. Pretreatment PSA velocity (PSAV) and PSA doubling time (PSADT) will likely continue to play a role in defining locally advanced prostate cancer. Imaging studies, especially high-field strength pelvic MRI, may provide additional information regarding the presence of locally advanced prostate cancer. In the future, molecular or genetic testing may permit further stratification of patients with locally advanced disease, who are at variable risk for recurrence and death after treatment. Future trials will need to assess the utility of multimodality treatments for patients in the diverse classification of locally advanced prostate cancer.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2008.03.007