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The clinical management of patients with a small volume of prostatic cancer on biopsy: what are the risks of progression?

Harnden, Patricia, Naylor, Brian, Shelley, Michael D., Clements, Hayley, Coles, Bernadette Mary and Mason, Malcolm David 2008. The clinical management of patients with a small volume of prostatic cancer on biopsy: what are the risks of progression? Cancer 112 (5) , pp. 971-981. 10.1002/cncr.23277

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Clinically localized prostate cancer is associated with a wide variation in biologic behavior, and men with the less aggressive form of the disease may never develop symptoms. There has been a rise in prostate cancer incidence in countries in which the blood test for prostatic-specific antigen (PSA) is common, and concerns have been expressed that this may be because of the increased detection of indolent disease, subjecting these men to unnecessary treatment and associated side effects. For the current review, the authors conducted a systematic evaluation of the literature regarding the outcomes of men who were diagnosed on the basis of a small volume of cancer in prostatic biopsies. The results indicated that, despite differences in study design and reporting, a significant proportion of patients with microfocal cancer, regardless of how it was defined, had adverse pathologic findings and a significant risk of PSA recurrence after undergoing radical prostatectomy. Biochemical and clinical recurrences also were observed after radiotherapy or watchful waiting. The authors concluded that patients with microfocal carcinoma on biopsy should be advised that their disease is not necessarily “insignificant” and should be counseled accordingly.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: Prostate cancer ; Biopsy ; Microfocal disease ; Insignificant cancer ; Systematic review ; Meta-analysis
Publisher: Wiley Blackwell
ISSN: 0008-543X
Last Modified: 10 Oct 2017 13:58

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