Fusion biopsy, salvage versus adjuvant radiation therapy, and superextended versus extended pelvic lymph node dissection are also covered in the take home messages on prostate cancer from the 2016 AUA annual meeting.
Robert Abouassaly, MD, MScFusion biopsy, salvage versus adjuvant radiation therapy, and superextended versus extended pelvic lymph node dissection are also covered in the take home messages on prostate cancer from the 2016 AUA annual meeting. The prostate cancer take homes were presented by Robert Abouassaly, MD, MSc, of University Hospitals Case Medical Center, Cleveland.
The effect of the United States Preventive Services Task Force's grade "D" recommendation against PSA-based screening for prostate cancer has been a decrease in screening since 2012 independent of race or insurance status, a decrease in referrals for an elevated serum PSA level, higher PSA levels at the time of referral, fewer prostate biopsies but more positive prostate biopsies, and a higher proportion of cancers with Gleason score greater-than-or-equal-to 8 and metastatic disease. Other series describe fewer prostatectomies performed, and of those being performed, there is a greater proportion being performed for Gleason score greater-than-or-equal-to 8 cancer as well as pathologic T3 disease and extraprostatic extension.
An evaluation of data from the European Randomised Study of Screening for Prostate Cancer found that 81% to 89% of the changes in prostate cancer mortality could be explained by a stage shift (cancers being detected at an earlier stage) rather than differences in treatment.
The risk of developing clinically significant prostate cancer with a baseline PSA <2 ng/mL at age 55 to 60 years is low at 5- and 13-year follow-up.
Use of the Prostate Health Index and multiparametric magnetic resonance imaging (MRI) in combination has better diagnostic performance than either alone in detecting clinically significant prostate cancer.
A multicenter validation study of a molecular urine test revealed that the HOXC6-DLX1 score model improved the accuracy of the detection of clinically significant prostate cancer over serum PSA alone.
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