Management of high-risk localized prostate cancer

The integration of local and systemic therapy approaches

Samira Syed, Daniel P. Petrylak, Ian M. Thompson

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Using a combination of PSA, Gleason score, and clinical stage, it is possible to identify a group of patients with prostate cancer who have a high risk of relapse following initial treatment (e.g., radiotherapy or radical prostatectomy). For these patients, multi-modal therapy may result in improved outcomes. We reviewed published literature to identify methods to identify high-risk patients as well as options for adjuvant or neoadjuvant therapy to reduce risk of disease recurrence. At the present time, the most promising adjuvant therapy is hormonal therapy following radiotherapy for locally advanced disease (T3-T4, or N1). In phase III trials in these patients, survival is improved. For all other applications, including adjuvant and neoadjuvant hormonal therapy, chemotherapy, or radiotherapy, the benefits are unclear. Perhaps most promising at this time, and the subject of a current phase III trial, is the utility of adjuvant chemotherapy in high-risk patients. It will be through the conduct of phase III trials that the benefits of multi-modal therapy will be evaluated. Patients with high-risk prostate cancer undergoing radiotherapy or surgery should be offered participation in these clinical trials.

Original languageEnglish (US)
Pages (from-to)235-243
Number of pages9
JournalSeminars in Urologic Oncology
Volume21
Issue number3
StatePublished - May 2003

Fingerprint

Risk Management
Prostatic Neoplasms
Radiotherapy
Neoadjuvant Therapy
Therapeutics
Recurrence
Neoplasm Grading
Adjuvant Chemotherapy
Prostatectomy
Clinical Trials
Drug Therapy
Survival

Keywords

  • Chemotherapy
  • High-risk
  • Hormonal therapy
  • Multi-modality therapy
  • Prostate cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Urology

Cite this

Management of high-risk localized prostate cancer : The integration of local and systemic therapy approaches. / Syed, Samira; Petrylak, Daniel P.; Thompson, Ian M.

In: Seminars in Urologic Oncology, Vol. 21, No. 3, 05.2003, p. 235-243.

Research output: Contribution to journalArticle

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