alexa Active surveillance with selective delayed intervention for favorable risk prostate cancer.
Oncology

Oncology

Archives of Surgical Oncology

Author(s): Klotz L

Abstract Share this page

Abstract Good risk prostate cancer, defined as a Gleason score of < or = 6, prostate-specific antigen (PSA) <10, and T1c-T2a, now constitutes 50\% of newly diagnosed prostate cancer. Recent data from the Prostate Cancer Prevention Trial, Stamey data set on PSA-prostate cancer correlations, and the Surveillance, Epidemiology, and End Results database make it very clear that a policy of PSA screening with biopsy for those patients in whom PSA is increased results in the diagnosis, and radical treatment, of a very large proportion of men who do not have life-threatening prostate cancer. Most men with good risk prostate cancer have indolent and slow growing disease. The challenge is to identify those patients who are unlikely to have significant progression, while offering radical therapy to those who are at risk. The approach to favorable risk prostate cancer described in this article uses estimation of PSA doubling time (DT) and repeat biopsy to stratify patients according to the risk of progression. Patients who select this approach are treated initially with active surveillance. Those patients who have a PSA DT of < or = 3 years (based on a minimum of 3 determinations over 6 months) are offered radical intervention. The remaining patients are closely monitored with serial PSA and periodic prostate repeat biopsy at 1, 4, 7, and 10 years. In one series of 299 patients treated in this way, 65\% remained free of treatment at 8 years. The prostate cancer specific survival using this approach was 99.3\% at 8 years. The majority of patients in this study remain on surveillance. Active surveillance with selective delayed intervention based on PSA DT is a practical middle ground between radical therapy for all, which results in over-treatment of patients with indolent disease, and watchful waiting with palliative therapy only, which results in under-treatment of those with aggressive disease. This article was published in Urol Oncol and referenced in Archives of Surgical Oncology

Relevant Expert PPTs

Relevant Speaker PPTs

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords