Radical prostatectomy or wait-and-watch?

Abstract:

:With intensified screening and the use of new diagnostic tools for prostate cancer (prostate-specific antigen, rectal ultrasound, magnetic resonance imaging with rectal coils, etc), the number of newly diagnosed cases of prostate cancer is rising rapidly, whereas the frequency of death due to prostate cancer remains almost stable. It must therefore be assumed that the number of patients in whom a diagnosed prostate cancer will not be fatal is also increasing. Consequently, not every prostatic carcinoma requires radical treatment when diagnosed. Also, it must be concluded that not every man who is a long-term survivor after radical prostatectomy owes his survival to the treatment. Long-term survivorship may reflect the relatively benign biological potential of this disease in an individual patient. Therefore, there is an inherent risk of overtreating patients and this must be weighed against the costs, the postoperative morbidity and the, albeit low, mortality of a radical prostatectomy. Nevertheless, as long as we do not have diagnostic tools which, at an early stage of prostate cancer, enable us to determine whether a carcinoma will ultimately have a fatal outcome, we are obliged to offer radical prostatectomy to younger patients (who have a life expectancy of more than 10 years) as long as they have organ-confined disease.

journal_name

Eur Urol

journal_title

European urology

authors

Studer UE,Thalmann G,Zingg EJ

doi

10.1159/000474384

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

24-8

eissn

0302-2838

issn

1873-7560

journal_volume

24 Suppl 2

pub_type

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