Therapeutic options in locally defined or advanced prostate cancer

被引:1
作者
Altwein, JE [1 ]
机构
[1] Hosp Barmherzige Bruder, Dept Urol, D-80639 Munich, Germany
关键词
prostate cancer; locally defined; locally advanced; therapeutic options;
D O I
10.1159/000052301
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective: Critical discussion of the available therapeutic options in locally defined or advanced prostate cancer (PCa) in the absence of standards or guidelines. Methods: Medline-based survey of the pertinent literature. The therapeutic options are presented stage-by-stage. Results: Intracapsular PCa (T-1a-T2bN0M0) is preferably managed by radical prostatectomy; 'insignificant' cancers may be treated expectantly. The outcome of irradiation is not as predictable as radical surgery. The following points regarding treatment of locally advanced PCa are still under debate: neoadjuvant treatment is probably not as efficient as believed; technical refinements of radical prostatectomy may be helpful; in some instances, the value of adjuvant treatment is undecided. The efficacy of irradiation in conjunction with androgen deprivation probably equals the efficacy of surgery. No consensus can be found in the presence of positive lymph nodes, although single institutions achieve remarkable results with surgery plus androgen deprivation. Conclusion: Prognostic factors beside the clinical stages and grades should be incorporated in the treatment decision, and quality-of-life measurement should gain more importance when the treatment outcome is assessed.
引用
收藏
页码:9 / 15
页数:7
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