Asset Details
Do you wish to reserve the book?
High-risk prostate cancer—classification and therapy
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
High-risk prostate cancer—classification and therapy
Do you wish to request the book?
High-risk prostate cancer—classification and therapy
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
High-risk prostate cancer—classification and therapy
2014
Overview
Key Points
Patients with high-risk prostate cancer have a significant chance of developing systemic or local recurrence, and are at higher risk for symptoms and/or death from the disease
Definitions vary for what constitutes high-risk disease in localized prostate cancer, but are historically based on clinicopathological findings including clinical stage, Gleason score, and PSA
The literature is limited as a consequence of variations in definition, lack of prospective randomized trials, limitations in statistical plan (underpowered studies), the need for long-term follow-up, and suboptimal end points
Several key principles for radiotherapy have been established, including the importance of dose, and the addition of androgen-deprivation therapy
Optimal surgical management requires completely removing the gland itself, confirming negative margins intraoperatively, and discussing the potential need for post-operative radiotherapy
Treatment of potential lymph-node involvement, either surgically or with extended pelvic radiation, is favoured in high-risk disease, but lacks level I evidence
High-risk prostate cancer includes a heterogeneous group of patients with a range of prognoses, with some that can be fatal. The optimal management of this patient subgroup is evolving. We critically evaluate the existing literature focused on defining the high-risk population, the management of patients with high-risk prostate cancer, and future directions to optimize care.
Approximately 15% of patients with prostate cancer are diagnosed with high-risk disease. However, the current definitions of high-risk prostate cancer include a heterogeneous group of patients with a range of prognoses. Some have the potential to progress to a lethal phenotype that can be fatal, while others can be cured with treatment of the primary tumour alone. The optimal management of this patient subgroup is evolving. A refined classification scheme is needed to enable the early and accurate identification of high-risk disease so that more-effective treatment paradigms can be developed. We discuss several principles established from clinical trials, and highlight other questions that remain unanswered. This Review critically evaluates the existing literature focused on defining the high-risk population, the management of patients with high-risk prostate cancer, and future directions to optimize care.
Publisher
Nature Publishing Group UK,Nature Publishing Group
