Management of Prostate Cancer: Advances and Controversies

Cover......Page 1
Management of Prostate Cancer......Page 3
Preface......Page 5
Contents......Page 7
Contributors......Page 11
INTRODUCTION......Page 17
RATIONALE FOR SURGICAL TREATMENT......Page 19
PATIENT SELECTION AND PROGNOSTIC FACTORS......Page 21
Age and Health......Page 22
Clinical Prognostic Factors......Page 23
Prostate Needle Biopsy Information......Page 27
Serum PSA Level......Page 28
Early Complications: Hemorrhage, Rectal Injury, and Thromboembolism......Page 29
Dorsal Vein Complex Remain......Page 34
Lateral Vascular Pedicles and Seminal Vesicles......Page 37
Late Complications: Bladder Neck Contracture and Incontinence......Page 39
Methods to Reduce Bladder Neck Contracture and Incontinence......Page 42
Late Complications: Positive Surgical Margins and Erectile Dysfunction......Page 46
Methods to Reduce Positive Surgical Margins and Preserve Erectile Function......Page 50
CANCER CONTROL AFTER RADICAL RETROPUBIC PROSTATECTOMY......Page 53
Pathologic Prognostic Factors......Page 54
RATIONALE FOR SELECTING RADICAL PROSTATECTOMY AS THE TREATMENT OF CHOICE FOR CLINICALLY LOCALIZED PROSTATE CANCER......Page 57
CONCLUSIONS......Page 61
REFERENCES......Page 62
Robert P. Myers......Page 71
REFERENCES......Page 75
Alan W. Partin......Page 76
Kenneth B. Cummings......Page 77
REFERENCES......Page 78
II. HISTORY OF THE PERINEAL PROSTATECTOMY......Page 79
III. RESURGENCE OF RADICAL PERINEAL PROSTATECTOMY......Page 82
IV. PATIENT SELECTION......Page 83
VI. ANESTHESIA......Page 84
A. Incision and Initial Exposure of the Prostate......Page 85
B. Continued Prostate Dissection and Preservation of the Cavernous Neurovascular Bundles......Page 89
C. Dissection of the Vas Deferens and Seminal Vesicles......Page 96
D. Vesicourethral Anastomosis......Page 97
E. Closure......Page 99
IX. POSTOPERATIVE CARE......Page 100
B. Rectal injury......Page 101
D. Other Morbidity Factors After Radical Perineal Prostatectomy......Page 105
E. Cancer Outcomes......Page 106
F. Urinary Continence......Page 108
G. Potency......Page 109
REFERENCES......Page 110
Michael J. Harris......Page 113
CANCER CONTROL......Page 119
URINARY CONTINENCE......Page 120
RETURN OF ERECTILE FUNCTION......Page 121
COMPLICATIONS......Page 124
REFERENCES......Page 125
GENERAL......Page 126
PROCEDURE......Page 127
Potency......Page 130
REFERENCES......Page 132
Philipp Dahm and David F. Paulson......Page 133
REFERENCES......Page 136
REFERENCES......Page 137
1. INTRODUCTION......Page 139
3. PREOPERATIVE PREPARATION AND PATIENT POSITION......Page 140
4. PORT PLACEMENT......Page 141
6. SURGICAL TECHNIQUE......Page 142
9. ONCOLOGIC RESULTS......Page 149
11. CONCLUSION......Page 152
REFERENCES......Page 153
Caner Z. Dinlenc......Page 154
THE VIEW IS IMPROVED......Page 157
APPROACH......Page 158
CANCER CONTROL......Page 159
SEXUAL FUNCTION......Page 160
Kenneth B. Cummings......Page 161
REFERENCES......Page 162
INTRODUCTION......Page 163
INDICATIONS AND CONTRAINDICATIONS......Page 164
SURGICAL TECHNIQUE......Page 165
B. Peritoneoscopy......Page 166
D. Creation of the Extraperitoneal Working Space.......Page 167
F. Control of the Dorsal Venous Complex......Page 168
G. Incision of the Bladder neck......Page 170
H. Dissection of the Vas Deferens, Seminal Vesicles, Prostatic Pedicles, and Incision of Denonvillier’s Fascia......Page 171
I. Nerve-Sparing......Page 172
K. Vesicourethral Anastomosis......Page 174
RESULTS......Page 176
COMPARISON OF VIP TO LAPAROSCOPIC RADICAL PROSTATECTOMY AND CONVENTIONAL RADICAL PROSTATECTOMY......Page 177
COMMENTS......Page 178
FUTURE HORIZONS......Page 179
REFERENCES......Page 180
David B. Samadi......Page 182
REFERENCES......Page 184
Kenneth B. Cummings......Page 185
REFERENCES......Page 186
INTRODUCTION......Page 187
What Is 3-D Conformal Radiation Therapy?......Page 188
How is 3-D Conformal Radiation Therapy Given?......Page 189
“Measuring Success”......Page 193
Comparison with Standard Radiation Therapy......Page 194
3-D CONFORMAL RADIATION THERAPY: LONG-TERM OUTCOME......Page 195
Comparison with Standard Radiation Therapy......Page 200
What Is Intensity Modulated Radiation Therapy?......Page 203
Neutrons......Page 205
Protons......Page 206
Future Directions......Page 207
REFERENCES......Page 209
Paul F. Schellhammer......Page 213
DOSE......Page 214
IMRT......Page 215
REFERENCES......Page 217
Kenneth B. Cummings......Page 218
REFERENCES......Page 219
INTRODUCTION......Page 221
HISTORY OF PROSTATE BRACHYTHERAPY......Page 222
PATIENT SELECTION......Page 223
INITIAL VOLUME STUDY......Page 225
SOURCE LOADING APPROACHES......Page 227
INTRA-OPERATIVE SEED PLACEMENT......Page 228
OUTCOME EVALUATION......Page 231
Introduction......Page 233
Materials and Methods......Page 234
Results......Page 236
MORBIDITY......Page 237
DISCUSSION......Page 239
CONCLUSIONS......Page 240
REFERENCES......Page 241
Molly Gabel......Page 242
REFERENCES......Page 244
Jay Y. Gillenwater......Page 245
Kenneth B. Cummings......Page 246
REFERENCES......Page 247
INTRODUCTION......Page 249
PATIENT SELECTION......Page 250
Radioactive Seed Implant......Page 251
External Beam Radiation Therapy......Page 253
SEQUENCING......Page 254
RADIATION DOSE......Page 255
HORMONE THERAPY AND CMT......Page 256
RESULTS......Page 257
TREATMENT-RELATED MORBIDITY......Page 258
REFERENCES......Page 261
Michael J. Droller......Page 265
Kenneth B. Cummings......Page 270
REFERENCES......Page 271
BACKGROUNDANDHISTORICAL PERSPECTIVES......Page 273
Second-Generation Prostate Cryoablation in the 1990s......Page 275
State of the ART CSAP......Page 276
CSAP: MORBIDITY AND COMPLICATIONS......Page 277
PATIENT SELECTION......Page 279
RESULTS OF PRIMARY CSAP......Page 280
RESULTS OF SALVAGE CSAP......Page 281
UCLA PROSTATE CRYOSURGICAL ABLATION TECHNIQUE......Page 282
Prostate Alignment with US Image, Aiming Grid and Insertion Template......Page 283
Cryoprobe Placement and Insertion......Page 284
Number of Probes......Page 285
Flexible Cystoscopy, Suprapubic Catheter Placement, and Urethral Warmer Insertion......Page 286
Freezing......Page 287
THIRDGENERATION CSAP: PRELIMINARY RESULTS......Page 290
REFERENCES......Page 291
Louis Pisters......Page 294
REFERENCES......Page 296
Kenneth B. Cummings......Page 297
REFERENCES......Page 298
INTRODUCTION......Page 299
FAILURE PATTERNS OF PROSTATE CANCER FOLLOWING RADICAL PROSTATECTOMY......Page 300
Incidence & Timing of Biochemical Recurrence......Page 301
Clinical Stage and Pathological Stage......Page 303
Surgical Margin Status......Page 304
PREDICTION OF PSA-ONLY PROGRESSION, LOCAL FAILURE, AND DISTANT FAILURE......Page 305
Digital Rectal Examination(DRE)and Biopsy of the Prostatic Bed......Page 306
Should the Urethrovesical Anastomosis Be Biopsied in Patients with Postradical Prostatectomy Biochemical Recurrence?......Page 307
Radiation Dose and Morbidity......Page 308
Timing of Radiation Therapy for Postradical Prostatectomy PSA-only Progression(Adjuvant Versus Delayed Salvage Radiation)......Page 309
Three-Dimensional Conformal External Beam Radiotherapy as Salvage Treatment for a Rising Postprostatectomy PSA......Page 311
Postradical Prostatectomy Radiotherapy Outcome......Page 312
SUMMARY AND CONCLUSIONS......Page 313
REFERENCES......Page 314
H. Ballentine Carter......Page 318
Kenneth B. Cummings......Page 320
REFERENCES......Page 321
10 Androgen Deprivation for Men with PSA-Only Failure Following Radical Prostatectomy: When?......Page 323
REFERENCES......Page 332
ANDROGEN DEPRIVATION FOR MEN WITH PSA-ONLY FAILURE FOLLOWING RADICAL PROSTATECTOMY: WHEN?......Page 335
REFERENCES......Page 338
Edward M. Messing......Page 339
REFERENCES......Page 342
E. David Crawford......Page 343
VETERANS ADMINISTRATION STUDIES(T3)......Page 344
MEDICAL RESEARCH COUNCIL STUDY......Page 345
HORMONAL THERAPY PLUS RADIATION: THE EUROPEAN ORGANIZATION PLUS RADIATION AND RADIATION THERAPY ONCOLOGY GROUP 8610......Page 346
EASTERN COOPERATIVE ONCOLOGY GROUP(D1)......Page 347
SUMMARY......Page 349
REFERENCES......Page 350
Kenneth B. Cummings......Page 351
REFERENCES......Page 353
11 Novel Therapies for PSA Progression in the Absence of Imagable Disease Following Local Therapy......Page 355
TIMING OF ANDROGEN ABLATION THERAPY......Page 356
CHEMOTHERAPY IN PATIENTS WITH PSA PROGRESSION?......Page 358
NEW APPROACHES TO THERAPY OF PSA PROGRESSION......Page 359
Novel Cytotoxic Agents......Page 360
Targeting Molecular Mechanisms of Tumor Growth and Death......Page 361
Growth Factors, Cytokines, and signal transduction......Page 364
Immunology......Page 366
FUTURE EFFORTS......Page 367
REFERENCES......Page 368
Neil H. Bander......Page 373
RISK PROGNOSTICATION IN THE TREATMENT DECISION......Page 375
TREATMENT BASED ON UNDERSTANDING PATIENT’S UNIQUE TUMOR BIOLOGY......Page 376
TARGETED THERAPIES IN THE MINIMAL AND METASTATIC DISEASE STATES......Page 377
HOW SHOULD SPECIFIC PATIENT POPULATIONS OR STATES PROCEED WITH TREATMENT?......Page 378
REFERENCES......Page 379
Kenneth B. Cummings......Page 380
REFERENCES......Page 382
INTRODUCTION......Page 383
THE RATIONALE FOR IMMUNOLOGIC TREATMENT OF PROSTATE CANCER......Page 384
Monoclonal Antibodies......Page 386
Cancer Vaccines......Page 389
Prostate-Specific Antigen(PSA)......Page 390
Prostate-Specific Membrane Antigen (PSMA)......Page 391
Prostatic Acid Phosphatase......Page 392
Prostate Stem Cell Antigen(PSCA)......Page 393
Epidermal Growth Factor Receptor......Page 394
HER2/neu......Page 395
Epithelial Mucins and Oligosaccharide Antigens......Page 396
Telomerase Reverse Transcriptase......Page 397
Vascular Epithelial Growth Factor and Matrix Metalloproteinases......Page 398
ANTIGEN DISCOVERY......Page 400
CONCLUSION......Page 401
REFERENCES......Page 402
Kenneth B. Cummings......Page 407
REFERENCES......Page 408
Index......Page 409