Using additional biopsy-scoring data may help determine prostate cancer...(d a significantly shorter time to PSA fa...),Health

Date:10/2/2007

d a significantly shorter time to PSA failure than men with 7 without tertiary grade 5 (median [midpoint] time, 5.0 vs. 6.7 years, respectively); or score of 6 or less (median time, 15.4 years). However, a significant difference was not observed when these men were compared with men with Gleason score 8 to10 disease (median time, 5.1 years).

If these findings are validated by additional studies in other populations, they may affect the management of care for men with Gleason score 7 prostate cancer for which the currently practiced management standards include dose-escalated radiation therapy including prostate brachytherapy [radiation therapy where the radioactive source is placed inside the prostate] with or without supplemental radiation therapy, radiation therapy and short course androgen suppression therapy (AST) or radical prostatectomy. Specifically, given the time to recurrence, management options for men with Gleason score 7 who also have tertiary grade 5 disease could include treatments that are the current standards of care for men with Gleason 8 to 10 prostate cancer, the authors write.

These standards of care based on the results of randomized trials include radiation therapy and short- or extended-course AST or radical prostatectomy with the expectation that further therapy may be needed postoperatively depending on the final pathology findings of the radical prostatectomy and postoperative PSA level.

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Contact: Lori Shanks 617-534-1604 JAMA and Archives Journals Source:Eurekalert

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