Localized PCa Treatment
Leonard G. Gomella, MD, reviewed abstracts on prostate cancer treatment and identified several key themes, including research examining the perennial debate over robotic versus open radical prostatectomy.
“The AUA abstracts relating to localized prostate cancer continue to identify improvements in outcomes with robotic vs. open radical prostatectomy. Although the absolute differences are often small, the statistical analyses do typically favor the robotic techniques,” said Dr. Gomella, professor and chairman of urology at Thomas Jefferson University, Philadelphia.
Also watch for new findings on focal and whole-gland ablation.
“With the approval in the U.S. of high-intensity focused ultrasound for the ablation of prostate tissue, there will be much interest in the abstracts that address focal and whole-gland ablation in prostate cancer, with the data suggesting encouraging outcomes,” Dr. Gomella said.
Other themes Dr. Gomella pointed to include:
- Several papers suggest that many men with high-risk prostate cancer treated by radical prostatectomy with persistent PSA elevation may not develop metastasis over the long term.
- Several European studies of extended lymph node dissections continue to demonstrate a positive impact on long-term disease control. “However, the data to be presented by several groups indicate that ‘super-extended LND’ may actually be detrimental,” Dr. Gomella said.
- Several papers will question the utility of multiparametric magnetic resonance imaging in the setting of radical prostatectomy.
Here are Dr. Gomella's selections from this year's poster and podium sessions:
MP18-15: EFFICACY OF HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) AS A PRIMARY MONOTHERAPY FOR LOW RISK LOCALIZED PROSTATE CANCER: OUTCOMES FROM THE ENLIGHT TRIAL
PD30-06: Assessing the role of time from prostate cancer diagnosis to radical prostatectomy: can surgery be postponed safely?
PD30-11: Prognostic factors for biochemical recurrence more than ten years after radical prostatectomy
MP57-03: Is a negative mpMRI really able to rule out significant prostate cancer?
MP57-12: The impact of infectious complications after prostate biopsy on radical prostatectomy surgical outcomes: A population-based analysis
MP57-13: The Effect of Smoking on 30-Day Morbidity Following Malignancy-Related Prostatectomy.
PD37-10: Long-term oncological outcomes in patients with biochemical recurrence after radical prostatectomy
PD37-11: Functional outcomes after extended vs. super-extended pelvic lymph node dissection for intermediate and high-risk localized prostate cancer.
MP69-15: Impact of weekday on radical prostatectomy outcomes
MP80-14: MRI Prior to Prostatectomy Does Not Improve Surgical Outcomes