Abstract:
BACKGROUND:Treatment of high-risk prostate cancer has evolved considerably over the past two decades, yet patients with very-high-risk features may still experience poor outcome despite aggressive therapy. We review the contemporary literature focusing on current definitions, role of modern imaging and treatment alternatives in very-high-risk prostate cancer. METHODS:We searched the MEDLINE database for all clinical trials or practice guidelines published in English between 2000 and 2016, with the following search terms: 'prostatic neoplasms' (MeSH Terms) AND ('high risk' (keyword) OR 'locally advanced' (keyword) OR 'node positive' (keyword)). Abstracts pertaining to very-high-risk prostate cancer were evaluated and 40 pertinent studies served as the basis for this review. RESULTS:The term 'very'-high-risk prostate cancer remains ill defined. The European Association of Urology and National Comprehensive Cancer Network guidelines provide the only available definitions, categorizing those with clinical stage T3-4 or minimal nodal involvement as very high risk irrespective of PSA level or biopsy Gleason score. Modern imaging with multiparametric magnetic resonance imaging and positron emission tomography-prostate-specific membrane antigen scans has a role in pre-treatment assessment. Local definitive therapy by external beam radiation combined with androgen deprivation is supported by several randomized clinical trials, whereas the role of surgery in the very-high-risk setting combined with adjuvant radiation/androgen deprivation therapy is emerging. Growing evidence suggest neoadjuvant taxane-based chemotherapy in the context of a multimodal approach may be beneficial. CONCLUSIONS:Men with very-high-risk tumors may benefit from local definitive treatment in the setting of a multimodal regimen, offering local control and possibly cure in well selected patients. Further studies are necessary to better characterize the 'very'-high-risk category and determine the optimal therapy for the individual patient.
journal_name
Prostate Cancer Prostatic Disjournal_title
Prostate cancer and prostatic diseasesauthors
Mano R,Eastham J,Yossepowitch Odoi
10.1038/pcan.2016.40subject
Has Abstractpub_date
2016-12-01 00:00:00pages
340-348issue
4eissn
1365-7852issn
1476-5608pii
pcan201640journal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:The combination of abiraterone acetate and prednisone (AA/P) is used to treat metastatic prostate cancer, but molecular predictors of treatment response are not well elucidated. We evaluated plasma circulating tumor DNA- (ctDNA-) based copy number alterations (CNAs) to determine treatment-related predictive ...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-020-0224-4
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Focal therapy is an emerging mini-invasive treatment modality for localized prostate cancer aimed to reduce the morbidity associated with radical therapy while maintaining optimal cancer control. We report the mid-term oncological and functional results of primary hemiablation high-intensity focused ultrasou...
journal_title:Prostate cancer and prostatic diseases
pub_type: 临床试验,杂志文章
doi:10.1038/pcan.2015.55
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Growing evidence suggests that men exposed to androgen deprivation therapy (ADT) have an increased risk of cardiovascular disease. While exercise has shown to attenuate some adverse effects of ADT, the effects on cardiometabolic health have not been systematically evaluated. OBJECTIVE:To evaluate the effect...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,评审
doi:10.1038/s41391-020-00273-5
更新日期:2020-08-28 00:00:00
abstract::With growing number of older adults in the United States and complexity of issues related to Medicare and other insurances more research is needed to evaluate an effectiveness of the different insurance types in prevention, screening and treatment of cancer. With prostate cancer being highly prevalent disease in older...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4501015
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Multidisciplinary team (MDT) meetings use precise prognostic factors to select treatment options for patients with prostate cancer. Comorbidity is judged subjectively. Recent publications favour the Charlson comorbidity score (CS) for the use in the management of prostate cancer. We assess the feasibility ...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4500889
更新日期:2006-01-01 00:00:00
abstract::An increased molecular understanding of localized prostate cancer and the improved ability for molecular testing of pathologic tissue has led to the development of multiple clinical assays. Here we review the relevant molecular biology of localized prostate cancer, currently available tissue-based tests and describe w...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,评审
doi:10.1038/pcan.2015.31
更新日期:2016-03-01 00:00:00
abstract::The aim of the present study was to evaluate how serum testosterone level (T) can affect urinary continence and erectile function in patients undergoing radical prostatectomy (RP). We included 257 patients with clinically localized prostate cancer, those who had filled out preoperative quality of life questionnaires (...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/pcan.2010.4
更新日期:2010-06-01 00:00:00
abstract::Randomized data from SWOG 8794 and EORTC 22911 confirm the benefit of post-operative radiation therapy (RT) for selected patients with pT3 prostate cancer (CaP) after radical prostatectomy (RP). However, data regarding the potential benefit of RT for patients post-RP with positive lymph node (+LN) involvement are limi...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4500940
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Several treatment options for clinically localized prostate cancer currently exist under the established guidelines. We aim to assess nationally representative trends in treatment over time and determine potential geographic variation using two large national claims registries. METHODS:Men with prostate can...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/pcan.2015.3
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Certain patients presenting with either low or very-low-risk prostate cancer (PCa) can represent a therapeutic dilemma for physicians. The oncologic outcomes of active surveillance (AS) for men with very-low-risk PCa are overall excellent. However, there are concerns about AS related to the potential for upg...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,评审
doi:10.1038/pcan.2016.56
更新日期:2017-06-01 00:00:00
abstract::Prostate cancer is the commonest non-skin malignancy in the United States and has a substantial mortality rate despite the use of PSA-based screening. Furthermore, therapy for prostate cancer by surgery, radiotherapy or hormonal manipulation carries a significant risk of treatment-related morbidity. Recent analysis of...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4500412
更新日期:2000-11-01 00:00:00
abstract:INTRODUCTION:Focal therapy (FT) ablates areas of prostate cancer rather than treating the whole gland. We compared oncological outcomes of FT to radical prostatectomy (RP). METHODS:Using prospective multicentre databases of 761 FT and 572 RP cases (November/2005-September/2018), patients with PSA < 20 ng/ml, Gleason <...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-020-00315-y
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Tumor contact length (TCL) is defined as the extent of contact between prostate cancer and the prostatic capsule, and its predictive value for microscopic extraprostatic extension (EPE) has been reported. However, the impact of the zonal origin (anterior or posterior tumor) of the tumor on the diagnosis of E...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-019-0136-3
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Gonadotrophin releasing hormone (GnRH) agonists and antagonists reduce testosterone levels for the treatment of advanced and metastatic prostate cancer. Androgen deprivation therapy (ADT) is associated with increased risk of cardiovascular (CV) events and CV disease (CVD), especially in patients with preexis...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-020-0264-9
更新日期:2020-07-31 00:00:00
abstract:BACKGROUND:While direct-to-consumer (DTC) medical advertising can provide useful information, it also risks oversimplification and being misleading. For an abbreviated prostate cancer treatment regimen called "ultrahypofractionation" (UHF), advertising has been used for CyberKnife (CK), a common delivery system for ste...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-020-0234-2
更新日期:2020-12-01 00:00:00
abstract::This literature review discusses the theoretical background of 5alpha-reductase inhibitor (5ARI) treatment and the resulting clinical implications. A Medline-based search for peer-reviewed articles addressing 5ARIs, benign prostatic hyperplasia and prostate cancer was performed. The 5ARIs Finasteride and Dutasteride, ...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,评审
doi:10.1038/pcan.2008.56
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Preclinical studies showing that pomegranate juice and its components inhibit prostate cancer led to multiple clinical trials to determine whether pomegranate products could slow the growth of prostate cancer. This review summarizes the preclinical data and discusses the results of the clinical trials. METH...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,评审
doi:10.1038/pcan.2017.19
更新日期:2017-09-01 00:00:00
abstract::In light of the growing interest in the concept of 'uroselectivity' and in the increased worldwide use of alpha-blockers for benign prostatic hyperplasia (BPH), this review evaluates the relative benefits of various alpha-blocking agents in the treatment of BPH. The pharmacological and physiological selectivity as wel...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4500302
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The Gleason grading system in prostatectomy specimens following receipt of neoadjuvant therapy has been considered inaccurate. However, with continuing expansion of novel therapeutics, it is important to understand whether the Gleason system can be effectively utilized in this setting. The aim of this study ...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/pcan.2014.30
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common problem with unclear etiology. Some diet and lifestyle factors were thought to correlate with CP/CPPS, but studies comprehensively investigate this correlation are rarely available. The current study was conducted to determine the potenti...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/pcan.2015.57
更新日期:2016-03-01 00:00:00
abstract::Vascular endothelial growth factor (VEGF) is a heparin-binding polypeptide growth factor. It is a potent mitogen for endothelial cells. Immunohistochemical localisation of VEGF was performed on 25 moderate to poorly differentiated stage T4 M+ prostate cancer specimens and 30 benign prostatic hyperplasia (BPH) specimen...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4500575
更新日期:2002-01-01 00:00:00
abstract::The present study seeks to establish a relationship between the quality of a surgical procedure and the subsequent hospital costs for that procedure by investigating the influence of both patient and peri-operative factors on the hospital costs of radical prostatectomy. All men who underwent radical prostatectomy at o...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/sj.pcan.4500529
更新日期:2001-01-01 00:00:00
abstract::This corrects the article DOI: 10.1038/pcan.2017.5. ...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,已发布勘误
doi:10.1038/pcan.2017.35
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Androgen deprivation therapy (ADT) has been shown to improve survival for men with intermediate and high-risk prostate cancer undergoing external-beam radiation therapy (EBRT). Using data from a community-based prospective disease registry, we investigated usage of EBRT with or without neoadjuvant ADT. METH...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-018-0084-3
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Technological advancements have led to the success of minimally invasive treatment modalities for prostate cancer such as CyberKnife and Cryotherapy. Here, we investigate patient-reported urinary function, bowel habits, and sexual function in patients following CyberKnife (CK) or Cryotherapy treatment, and c...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-017-0004-y
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Agent Orange (AO) was previously identified as a significant risk factor for biochemical recurrence (BCR) after radical prostatectomy (RP) in prostate cancer patients. In this study, we determined the levels of dioxin biological toxicity using toxic equivalency (TEQ) values and examined the impact of dioxin-...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/pcan.2013.33
更新日期:2013-12-01 00:00:00
abstract::The role of neoadjuvant androgen deprivation (NAD) in high-risk prostate cancer patients receiving high-dose radiotherapy (RT) remains unstudied. To evaluate the effect of a course of NAD, we reviewed the experiences of three institutions treating these patients with combined RT and high-dose rate brachytherapy (HDR)....
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,多中心研究
doi:10.1038/sj.pcan.4500882
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Several randomized control trials (RCTs) have showed that adding either abiraterone acetate (AA) or docetaxel (D) to androgen-deprivation therapy (ADT) improves survival of metastatic castration-sensitive prostate cancer patients (mCSPC). Yet, the cost-effectiveness of these treatment options has not been fu...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/s41391-019-0161-2
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:To assess the added value of biopsy factors, like maximum cancer length in a core (MCL), cumulative cancer length (CCL), cumulative length of positive cores (CLPC), percentage of cancer involvement in positive cores (CIPC) and the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria i...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章
doi:10.1038/pcan.2015.26
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Intermittent androgen deprivation (IAD) for prostate cancer was studied with the objective of reducing the side effects of treatment and potentially delaying the development of hormone resistance. There also appears to be a quality of life benefit during off-treatment intervals owing to the recovery of serum...
journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1038/pcan.2012.12
更新日期:2012-09-01 00:00:00