Available online at www.sciencedirect.com
ScienceDirect EJSO 40 (2014) 496e504
www.ejso.com
Review
Defining prostate cancer risk after radical prostatectomy S. Adamis*, I.M. Varkarakis 2nd Department of Urology, University of Athens, Medical School, Sismanoglion Hospital, Athens, Greece Accepted 2 February 2014 Available online 20 February 2014
Abstract Prostate cancer encompasses a wide spectrum of tumor phenotypes with differing prognoses and a part of these patients are at risk of experiencing tumor recurrence after initial treatment. This review discusses the parameters that determine PCa risk for failure after radical prostatectomy and also focuses on the ability of currently available post-treatment nomograms to predict treatment outcomes, and probability of treatment failure. The use of predictive nomograms may be therefore helpful in the complex decision making process. Ó 2014 Elsevier Ltd. All rights reserved. Keywords: Prostate cancer; Radical prostatectomy; Adverse features; Predictive nomograms
Introduction Prostate cancer (PCA) is the most common solid neoplasm in Western countries, outnumbering lung and colorectal cancer.1 Each year 500.000 new patients will be diagnosed with this disease2 and PCa is currently still the second most common cause of cancer death in men,3 despite the fact that many articles in the news suggest that prostate cancer is an indolent disease not deserving treatment. During the last 2 decades screening with PSA has allowed detection of PCA at earlier stages, improving patient survival and the chances of cure with definitive local therapy. The rate of clinically advanced disease was reduced from 41% in the 80’s to
ScienceDirect EJSO 40 (2014) 496e504
www.ejso.com
Review
Defining prostate cancer risk after radical prostatectomy S. Adamis*, I.M. Varkarakis 2nd Department of Urology, University of Athens, Medical School, Sismanoglion Hospital, Athens, Greece Accepted 2 February 2014 Available online 20 February 2014
Abstract Prostate cancer encompasses a wide spectrum of tumor phenotypes with differing prognoses and a part of these patients are at risk of experiencing tumor recurrence after initial treatment. This review discusses the parameters that determine PCa risk for failure after radical prostatectomy and also focuses on the ability of currently available post-treatment nomograms to predict treatment outcomes, and probability of treatment failure. The use of predictive nomograms may be therefore helpful in the complex decision making process. Ó 2014 Elsevier Ltd. All rights reserved. Keywords: Prostate cancer; Radical prostatectomy; Adverse features; Predictive nomograms
Introduction Prostate cancer (PCA) is the most common solid neoplasm in Western countries, outnumbering lung and colorectal cancer.1 Each year 500.000 new patients will be diagnosed with this disease2 and PCa is currently still the second most common cause of cancer death in men,3 despite the fact that many articles in the news suggest that prostate cancer is an indolent disease not deserving treatment. During the last 2 decades screening with PSA has allowed detection of PCA at earlier stages, improving patient survival and the chances of cure with definitive local therapy. The rate of clinically advanced disease was reduced from 41% in the 80’s to
