Sanoj Punnen1, Matthew R Cooperberg. 1. Helen Diller Comprehensive Cancer Center, University of California, San Francisco, California, USA.
Abstract
PURPOSE OF REVIEW: Concern for over and under-treatment of men with prostate cancer has led to an increased focus on the identification and selective treatment of men with high-risk features. The purpose of this review is to summarize the epidemiology, risk factors, and treatment trends of men with high-risk prostate cancer. RECENT FINDINGS: Findings from recent trials on prostate-specific antigen-based screening suggest that screening has substantially reduced the incidence of high-risk prostate cancer. Men with high-risk disease tend to be older at diagnosis than those with low-risk disease. There is marked variation in the treatment of men with high-risk features; contemporary studies favor multimodal therapy, but high-risk disease is often under-treated with androgen deprivation alone, particularly among older men. SUMMARY: Variations in the incidence, mortality, and treatment of men with high-risk prostate cancer may reflect heterogeneity among studies in the definition of high-risk disease. Future research should attempt to standardize definitions of high-risk prostate cancer to allow better comparison between studies and provide a more homogeneous assessment of natural history.
PURPOSE OF REVIEW: Concern for over and under-treatment of men with prostate cancer has led to an increased focus on the identification and selective treatment of men with high-risk features. The purpose of this review is to summarize the epidemiology, risk factors, and treatment trends of men with high-risk prostate cancer. RECENT FINDINGS: Findings from recent trials on prostate-specific antigen-based screening suggest that screening has substantially reduced the incidence of high-risk prostate cancer. Men with high-risk disease tend to be older at diagnosis than those with low-risk disease. There is marked variation in the treatment of men with high-risk features; contemporary studies favor multimodal therapy, but high-risk disease is often under-treated with androgen deprivation alone, particularly among older men. SUMMARY: Variations in the incidence, mortality, and treatment of men with high-risk prostate cancer may reflect heterogeneity among studies in the definition of high-risk disease. Future research should attempt to standardize definitions of high-risk prostate cancer to allow better comparison between studies and provide a more homogeneous assessment of natural history.
Authors: Corbin D Jacobs; Stephen G Chun; Jingsheng Yan; Xian-Jin Xie; David A Pistenmaa; Raquibul Hannan; Yair Lotan; Claus G Roehrborn; Kevin S Choe; D W Nathan Kim Journal: Cancer Biol Ther Date: 2014-03-21 Impact factor: 4.742
Authors: Badrinath Konety; Stephen M Zappala; Dipen J Parekh; Danielle Osterhout; Jeffrey Schock; Randy M Chudler; Gregory M Oldford; Kenneth M Kernen; Jason Hafron Journal: Rev Urol Date: 2015