Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update

Abstract

You have accessJournal of UrologyAdult urology1 Jun 2007Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Updateis accompanied byQuantifying the Impact of Prostate Volumes, Number of Biopsy Cores and 5α-Reductase Inhibitor Therapy on the Probability of Prostate Cancer Detection Using Mathematical Modeling Ian Thompson, James Brantley Thrasher, Gunnar Aus, Arthur L. Burnett, Edith D. Canby-Hagino, Michael S. Cookson, Anthony V. D’Amico, Roger R. Dmochowski, David T. Eton, Jeffrey D. Forman, S. Larry Goldenberg, Javier Hernandez, Celestia S. Higano, Stephen R. Kraus, Judd W. Moul, Catherine M. Tangen, and Prostate Cancer Clinical Guideline Update Panel Ian ThompsonIan Thompson Financial interest and/or other relationship with Mission Pharmacal, AstraZeneca and National Institutes of Health. More articles by this author , James Brantley ThrasherJames Brantley Thrasher Financial interest and/or other relationship with Medidiom and Abbott. More articles by this author , Gunnar AusGunnar Aus Financial interest and/or other relationship with Bok Medical. More articles by this author , Arthur L. BurnettArthur L. Burnett Financial interest and/or other relationship with Pfizer, Lilly ICOS and Guilford/MOI Pharma. More articles by this author , Edith D. Canby-HaginoEdith D. Canby-Hagino More articles by this author , Michael S. CooksonMichael S. Cookson Financial interest and/or other relationship with Sanofi-Aventis, GlaxoSmithKline, Envisioneering Medical Technologies, Aeterna Zentaris Solvay, Photocure, National Institutes of Health and GTX. More articles by this author , Anthony V. D’AmicoAnthony V. D’Amico More articles by this author , Roger R. DmochowskiRoger R. Dmochowski Financial interest and/or other relationship with Indevus, Watson Pharmaceuticals and Bard. More articles by this author , David T. EtonDavid T. Eton More articles by this author , Jeffrey D. FormanJeffrey D. Forman More articles by this author , S. Larry GoldenbergS. Larry Goldenberg More articles by this author , Javier HernandezJavier Hernandez More articles by this author , Celestia S. HiganoCelestia S. Higano More articles by this author , Stephen R. KrausStephen R. Kraus Financial interest and/or other relationship with National Institute for Diabetes and Digestive and Kidney Diseases, Pfizer, Atellas, Novartis and Ortho McNeil. More articles by this author , Judd W. MoulJudd W. Moul Financial interest and/or other relationship with AstraZeneca, Pfizer, Sanofi-Aventis and GlaxoSmithKline. More articles by this author , Catherine M. TangenCatherine M. Tangen More articles by this author , and Prostate Cancer Clinical Guideline Update Panel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.03.003AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction In December 1995, the AUA published the Report on the Management of Clinically Localized Prostate Cancer.1 The document was the culmination of six years of work by 17 clinicians and scientists and required the evaluation of 12,501 scientific publications with the detailed extraction of information from 165 papers that met the rigorous criteria of the panel of experts (Appendix 1 on-line). The Panel noted that a lack of evidence precluded specific recommendations for optimal treatment of an individual patient, which patients should be offered all treatment options, and that patient preferences should guide decision making. Since 1995, approximately 2,600,000 men2 in the United States have been diagnosed with prostate cancer, and nearly 375,000 men3,4 have lost their lives to this disease. In addition, the National Cancer Institute4 has spent $2.1 billion on prostate cancer research and as of November 2005, approximately 28,111 scientific papers concerning prostate cancer have been published in peer-reviewed medical journals (OVID Search, December 31, 1995 to October 23, 2005; key word: prostatic neoplasms). At the same time, mortality rates from prostate cancer have been declining: 34,475 men died in 1995 compared with an estimated 30,350 in 2005.4 Several pivotal RCTs related to prostate cancer treatment have been completed, including a chemoprevention study,5 along with studies demonstrating prolongation of life in men with hormone-refractory metastatic disease6,7 and improved outcomes in men with nonmetastatic disease.8–35 With the use of new and combined treatments, the frequency and variety of complications have differed from those previously reported. Advances have been made in prostate cancer imaging, biopsy methodology, in understanding causative factors and disease, in treatment-related QOL and in predicting the behavior of individual tumors using risk strata. Despite these advances, no consensus has emerged regarding the optimal treatment for the most common patient with prostate cancer: the man with clinically localized stage T1 to T2 disease