Title: Advanced prostate cancer: place of surgery
Authors: Van Poppel, Hendrik #
Issue Date: Oct-2005
Publisher: Pergamon-elsevier science ltd
Host Document: EJC Supplements vol:3 issue:3 pages:305-308
Conference: ECCO 13 Education Book date:30 October - 3 November 2005
Abstract: Introduction
The definition of advanced prostate cancer is confusing:
T4, T3b and also T3a prostate cancer stages
are considered by many as advanced diseases and the
treatment advocated is often hormonal treatment in
combination with radiotherapy. Furthermore, clinically
node positive, pathologically node positive and metastatic
disease, either asymptomatic or symptomatic
all belong to the group of advanced prostate cancers
as well as hormone sensitive and hormone refractory
prostate cancer.
It is therefore not obvious how to distinguish early
from advanced prostate cancer. To which category
belongs a pT2-3 with negative surgical margins and
PSA persistence, a pT2-3 with positive surgical
margins, and a pT4? To which category belongs
the radical prostatectomy patient with PSA (Prostate
Specific Androgen) persistence, with early PSA rise,
with late PSA recurrence or the patient who was
treated with radiotherapy who never reached a PSA
nadir below 1 ng/ml or who has PSA relapse after
having reached an initial nadir?
It is therefore proposed to use the terminology
of early prostate cancer for the T1T2 cases and to
consider as locally advanced all tumors that are
clinically extending outside the prostate capsule (T3-4)
for which local treatment could still be an option.
Advanced prostate cancer is then the terminology to
be used for the Tx N+M+ patients where cure cannot
be obtained by local treatment.
ISSN: 1359-6349
Publication status: published
KU Leuven publication type: IC
Appears in Collections:Urology Section (-)
# (joint) last author

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