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Can we improve the definition of high-risk, hormone naïve, non-metastatic prostate cancer?

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Tombal, Bertrand [UCL] Alcaraz, Antonio James, Nicholas Valdagni, Riccardo Irani, Jacques

To identify criteria beyond Tumour-Node-Metastasis (TMN)-, prostate-specific antigen (PSA)- and Gleason score-based standard classifications to enhance the stratification of non-metastatic high-risk prostate cancer. A detailed search of the literature was performed using PubMed. The authors reviewed the literature and used a modified Delphi approach to identify relevant approaches to enhance standard classifications. Specific criteria for high-risk prostate cancer vary across guidelines and clinical trials, reflecting the differing perspectives concerning the definition of 'risk' between different specialities within the urology/radiation oncology community. In addition to the present classifications, evidence exists that the measure of cancer volume can provide additional prognostic value. More accurate imaging, especially multiparametric magnetic resonance imaging can also provide information concerning staging and cancer volume, and thus may assist in the identification of patients with high-risk prostate cancer. A refined definition of non-metastatic high-risk prostate cancer is proposed. Within this high-risk cohort, patients with multiple high-risk criteria are especially at risk of prostate cancer-specific mortality.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès restreint
Publication date 2014
Language Anglais
Journal information "BJU International" - Vol. 113, no. 2, p. 189-199 (2014)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing Ltd. ((United Kingdom) Oxford)
issn 1464-4096
e-issn 1464-410X
Publication status Publié
Affiliations UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation
UCL - (SLuc) Service d'urologie
MESH Subject Cohort Studies ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Risk Assessment ; Sensitivity and Specificity ; Tumor Markers, Biological ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Practice Guidelines as Topic ; Prognosis
Keywords prostate cancer ; high-risk prostate cancer ; risk stratification
Links
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Bibliographic reference Tombal, Bertrand ; Alcaraz, Antonio ; James, Nicholas ; Valdagni, Riccardo ; Irani, Jacques. Can we improve the definition of high-risk, hormone naïve, non-metastatic prostate cancer?. In: BJU International, Vol. 113, no. 2, p. 189-199 (2014)
Permanent URL http://hdl.handle.net/2078.1/144379