Most Read Articles
5 days ago
In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course

Cancer progression common in men who undergo deferred prostatectomy

11 Sep 2018
Prostate cancer is a silent killer. Many may not be aware of the illness until it is too late.

Despite active surveillance, cancer progression appears to be common in men who undergo deferred radical prostatectomy (RP), according to a recent study.

The study included 132 men with screening-detected prostate cancer (median age 64 years) who received radical prostatectomy following active surveillance. Radical prostatectomy was performed upon detection of disease progression or patient request. Active surveillance included prostate-specific antigen (PSA) tests every 3–6 months and biopsies every 2–4 years.

The median time from prostate cancer diagnosis to RP was 1.9 years, during which the participants received a median of one repeat biopsy for active surveillance.

At deferred RP, 52 patients (39 percent) showed at least one unfavourable pathology in the RP specimen. For instance, 35 percent (n=46) of the participants demonstrated an increase in Gleason score (GS) from diagnostic biopsy. Twelve men (9.1 percent) had GS >3+4.

Moreover, 22 percent (n=29) were positive for extraprostatic extensions, 3.0 percent (n=4) had seminal vesicle invasion, 22 percent (n=29) demonstrated positive surgical margins, and 0.8 percent (n=1) had positive lymph nodes. The median tumour volume was 0.70 mL.

PSA relapse was reported in 25 men, 10 of whom underwent salvage radiation. The resulting 10-year PSA relapse-free survival was 79.5 percent.

At the time of diagnostic biopsy, 29 percent (n=38) of the patients had unidentifiable index tumours. At the last repeat biopsy before the deferred surgery, index tumour was not identified in 22 participants (21 percent).

Clinicians can use the findings in counselling prostate cancer patients who choose to undergo active surveillance and deferred RP, researchers said, adding that there is a need to improve the detection of cancer progression during active surveillance.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Oncology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
5 days ago
In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course