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How long can surgery be safely delayed in men with low risk PCa?

bdhilton
Posts: 797
Joined: Jan 2010

Another interesting article in the new Quest magazine published by the Urological Research Foundation..."It should be online soon however, in 2 important areas, the delay did show statistical effect.

A surgical delay of six months or more
1. was associated with a significantly greater proportion of Gleason score 7-10 tumors on final pathology examination of the prostate specimen and
2. was associated with more than double the frequency of cancer recurrence…(specifically the recurrence rate was 5% in men with early RP compared to 12% of those treated at or beyond months of diagnosis)...

The study concludes: A delay in having RP for 6 months or longer after diagnosis shows statistically significant adverse association in outcomes, specifically more high-grade disease and more recurrence.

Low risk patients should be counseled about the possibility of worse outcomes with a delay in surgical treatment...”

Again complete article should be available online soon… http://www.drcatalona.com/quest.asp

Kongo's picture
Kongo
Posts: 1166
Joined: Mar 2010

Well, such a study would be very interesting to read when it is available. From the brief information provided above, such a report would appear to be the opposite of several other fairly recent studies that indicated there was little risk in delaying treatment.

I look forward to reading it when it is posted.

bdhilton
Posts: 797
Joined: Jan 2010

Kongo…:-) If you are truely interested then call up Urological Reseaach foundation or request it online.

The folks on the study are Carvalhal, Loeb, Kan, Hofer, Casey, Helfand, O’Brien, Catalona and the study was supported in part Urological Research Foundation, Prostate SPORE grant and the Robert H. Lurie Comprehensive Cancer Center grant…

Kongo's picture
Kongo
Posts: 1166
Joined: Mar 2010

BD, I am very interested in seeing the study and have already been to the website to look for it but am assuming it will be out shortly in their Quest series.

The prevailing tone of many recent studies (and books such as "Invasion of the Prostate Snatchers") has been that, depending on age at diagnosis, AS is a very viable protocol for low risk cancer, particularly for men over 65 and that there is no harm in delaying treatment.

If the Catalona study shows that indeed there is a measurable risk in waiting which results in a higher Gleason score or higher incidence of recurrence, then I expect it would cause a lot of those pursuing AS to rethink their approach and urologists ought to be counseling their patients accordingly.

I'll reserve judgement until I read the details but suspect that it will be a sobering analysis.

bdhilton
Posts: 797
Joined: Jan 2010

At the end of the day it is all about who you want to believe and what you want to believe (and from my perspective believing is part of the battle here) but these guys do have credibility…I say leave no rock up turned in dealing with this PCa Beast…Peace

mrspjd
Posts: 694
Joined: Apr 2010

It would be most interesting to learn exactly what parameters and definition were used for identifying or categorizing "low risk PCa" participants in the Catalona (RP surgeon) study. Those add'l facts might possibly be the most telling information related to the stated initial "study finding." Guess we'll just have to wait to read the full study design, criteria & data.

Is this info available yet?

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