Multiparametric magnetic resonance imaging, the U.S. Preventive Services Task Force updated PSA screening recommendation, and the landmark advanced prostate cancer trials STAMPEDE and LATITUDE were among this year’s highlights in the peer-reviewed literature for prostate cancer, according to Urology Times Editorial Advisory Board members Leonard G. Gomella, MD; Stacy Loeb, MD, MS; and J. Brantley Thrasher, MD. As part of our continuing review of 2017, Urology Times asked Drs. Gomella, Loeb, and Thrasher to identify the most noteworthy peer-reviewed papers on prostate cancer from this year.
Their complete selections and comments follow.
Leonard G. Gomella, MD, professor and chairman of urology, Thomas Jefferson University, Philadelphia
Intratumoral and Intertumoral Genomic Heterogeneity of Multifocal Localized Prostate Cancer Impacts Molecular Classifications and Genomic Prognosticators. Eur Urol 2017; 71:183-92.
Genomic analysis of localized prostate cancer has become commonplace in clinical decision-making and has been supported by groups such as the National Comprehensive Cancer Network. This paper identified significant genomic diversity in an individual patient with multiple tumor loci. The authors conclude that genomic analysis from a single biopsy site may not be sufficient to guide treatment decisions and suggest reconsidering how this genomic data is analyzed.
What Are We Missing? False-Negative Cancers at Multiparametric MR Imaging of the Prostate. Radiology 2017; Oct 20:152877.
Multiparametric magnetic resonance imaging can provide useful information in the management of localized prostate cancer. However, there are growing data that clinically important lesions can be missed or their size can be underestimated on prostate MR imaging. Objective recognition of the limitations by leaders in the field will lead to new approaches to reduce these false-negative rates.
Randomized Trial of a Hypofractionated Radiation Regimen for the Treatment of Localized Prostate Cancer. J Clin Oncol 2017; 35:1884-90.
Multiple studies have suggested the duration of radiation therapy can be decreased for many men with localized prostate cancer without compromising efficacy, a concept known as hypofractionation. This long-term study, known as the PROFIT trial, together with evidence from other randomized studies, demonstrates there is the potential for cost savings and enhanced convenience for patients with this radiation approach for localized intermediate-risk prostate cancer.