
pmid: 25727526
The Vall d'Hebron multidisciplinary prostate cancer (PC) team reviews recent advances in the management of this neoplasm. Screening studies with long follow-up show a reduction in mortality, whereas active surveillance is emerging as a therapeutic approach of non-aggressive cancers. New markers increase the specificity of PSA and also allow targeting suspected aggressive cancers. Multiparametric magnetic resonance (mMRI) has emerged as the most effective method in the selection of patients for biopsy and also for local tumor staging. The paradigm of random prostatic biopsy is changing through the fusion techniques that allow guiding ultrasonography-driven biopsy of suspicious areas detected in mMRI. Radical prostatectomy (RP) and radiotherapy (RT) are curative treatments of localized PC and both have experienced significant technological improvements. RP is highly effective and the incorporation of robotic surgery is reducing morbidity. Modern RT allows the possibility of high tumor dose with minimal adjacent dose reducing its toxicity. Androgen deprivation therapy with LHRH analogues remains the treatment of choice for advanced PC, but should be limited to this indication. The loss of bone mass and adverse metabolic effects increases the frequency of fractures and cardiovascular morbimortality. After castration resistance in metastatic disease, new hormone-based drugs have demonstrated efficacy even after chemotherapy resistance.
Diagnostic Imaging, Male, Prostatectomy, Salvage Therapy, Antineoplastic Agents, Hormonal, Radiotherapy, Biopsy, Needle, Prostatic Neoplasms, Androgen Antagonists, Adenocarcinoma, Multimodal Imaging, Antineoplastic Combined Chemotherapy Protocols, Humans, Lymph Node Excision, Watchful Waiting, Orchiectomy, Ultrasonography, Interventional, Neoplasm Staging, Randomized Controlled Trials as Topic
Diagnostic Imaging, Male, Prostatectomy, Salvage Therapy, Antineoplastic Agents, Hormonal, Radiotherapy, Biopsy, Needle, Prostatic Neoplasms, Androgen Antagonists, Adenocarcinoma, Multimodal Imaging, Antineoplastic Combined Chemotherapy Protocols, Humans, Lymph Node Excision, Watchful Waiting, Orchiectomy, Ultrasonography, Interventional, Neoplasm Staging, Randomized Controlled Trials as Topic
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 12 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Top 10% |
