Maximizing outcomes in genitourinary cancers across the treatment continuum.

Hdl Handle:
http://hdl.handle.net/10147/132533
Title:
Maximizing outcomes in genitourinary cancers across the treatment continuum.
Authors:
Fitzpatrick, John M; Bellmunt, Joaquim; Dreicer, Robert; Fleshner, Neil E; Logothetis, Christopher J; Moul, Judd W; Tombal, Bertrand; Zlotta, Alexandre
Affiliation:
Department of Surgery, Mater Misericordiae Hospital and University College Dublin, Dublin, Ireland.
Citation:
Maximizing outcomes in genitourinary cancers across the treatment continuum. 2011, 107 Suppl 2:1-12 BJU Int.
Journal:
BJU international
Issue Date:
Apr-2011
URI:
http://hdl.handle.net/10147/132533
DOI:
10.1111/j.1464-410X.2010.10035.x
PubMed ID:
21382149
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/21382149
Abstract:
Key controversies concerning the management of genitourinary cancers across the treatment continua were discussed at the second annual Interactive Genitourinary Cancer Conference (IGUCC) held in February 2010 in Athens, Greece. Prostate cancer is the most common form of cancer among western men and prevention strategies are needed. Trials evaluating 5α-reductase inhibitors have reported beneficial and clinically meaningful results, but uptake remains low for primary prostate cancer prevention. Prostate cancer detection programmes are also important as curative treatments for advanced disease are unavailable. Two large landmark randomized controlled trials reported conflicting results concerning screening efficacy and uncovered high levels of over-diagnosis and potential over-treatment. Tailored management strategies after diagnosis are important and predictive markers that distinguish between aggressive and indolent tumours are needed. The majority of newly diagnosed cases of prostate cancer are clinically localized. Active surveillance of favourable risk patients may be beneficial in the intermediate term, while an integrated approach of multi-modality therapy in patients with adverse features is recommended. The benefits of new technologies such as high-intensity focused ultrasound (HIFU) and robotic prostatectomy have not been established in prospective randomized trials vs current standards of care. A multidisciplinary approach is essential to evolving the management of advanced prostate cancer into a chronic disease paradigm. Docetaxel plus prednisone is the standard first-line chemotherapy for patients with metastatic castration-resistant prostate cancer (mCRPC), but the optimal timing of chemotherapy initiation has not been addressed in randomized clinical trials. Retrospective analyses suggest that asymptomatic patients with adverse prognostic factors for survival may also benefit from receiving chemotherapy. Bladder cancer is a common malignancy and the most expensive cancer per patient. Non-muscle-invasive bladder cancer is a heterogenous disease that requires dynamic multidisciplinary management. Aggressive early intervention may be beneficial in some cases. Platinum-based therapies represent the first-line standard of care for advanced bladder cancer, but the maximum benefit may have been reached for conventional chemotherapies and new strategies are needed. Several ongoing clinical trials are assessing combination chemotherapy and targeted therapy.
Item Type:
Article
Language:
en
MeSH:
Aged; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Cystectomy; Female; High-Intensity Focused Ultrasound Ablation; Humans; Male; Middle Aged; Prostatectomy; Prostatic Neoplasms; Randomized Controlled Trials as Topic; Treatment Outcome; Urinary Bladder Neoplasms; Watchful Waiting
ISSN:
1464-410X

Full metadata record

DC FieldValue Language
dc.contributor.authorFitzpatrick, John Men
dc.contributor.authorBellmunt, Joaquimen
dc.contributor.authorDreicer, Roberten
dc.contributor.authorFleshner, Neil Een
dc.contributor.authorLogothetis, Christopher Jen
dc.contributor.authorMoul, Judd Wen
dc.contributor.authorTombal, Bertranden
dc.contributor.authorZlotta, Alexandreen
dc.date.accessioned2011-06-03T10:02:28Z-
dc.date.available2011-06-03T10:02:28Z-
dc.date.issued2011-04-
dc.identifier.citationMaximizing outcomes in genitourinary cancers across the treatment continuum. 2011, 107 Suppl 2:1-12 BJU Int.en
dc.identifier.issn1464-410X-
dc.identifier.pmid21382149-
dc.identifier.doi10.1111/j.1464-410X.2010.10035.x-
dc.identifier.urihttp://hdl.handle.net/10147/132533-
dc.description.abstractKey controversies concerning the management of genitourinary cancers across the treatment continua were discussed at the second annual Interactive Genitourinary Cancer Conference (IGUCC) held in February 2010 in Athens, Greece. Prostate cancer is the most common form of cancer among western men and prevention strategies are needed. Trials evaluating 5α-reductase inhibitors have reported beneficial and clinically meaningful results, but uptake remains low for primary prostate cancer prevention. Prostate cancer detection programmes are also important as curative treatments for advanced disease are unavailable. Two large landmark randomized controlled trials reported conflicting results concerning screening efficacy and uncovered high levels of over-diagnosis and potential over-treatment. Tailored management strategies after diagnosis are important and predictive markers that distinguish between aggressive and indolent tumours are needed. The majority of newly diagnosed cases of prostate cancer are clinically localized. Active surveillance of favourable risk patients may be beneficial in the intermediate term, while an integrated approach of multi-modality therapy in patients with adverse features is recommended. The benefits of new technologies such as high-intensity focused ultrasound (HIFU) and robotic prostatectomy have not been established in prospective randomized trials vs current standards of care. A multidisciplinary approach is essential to evolving the management of advanced prostate cancer into a chronic disease paradigm. Docetaxel plus prednisone is the standard first-line chemotherapy for patients with metastatic castration-resistant prostate cancer (mCRPC), but the optimal timing of chemotherapy initiation has not been addressed in randomized clinical trials. Retrospective analyses suggest that asymptomatic patients with adverse prognostic factors for survival may also benefit from receiving chemotherapy. Bladder cancer is a common malignancy and the most expensive cancer per patient. Non-muscle-invasive bladder cancer is a heterogenous disease that requires dynamic multidisciplinary management. Aggressive early intervention may be beneficial in some cases. Platinum-based therapies represent the first-line standard of care for advanced bladder cancer, but the maximum benefit may have been reached for conventional chemotherapies and new strategies are needed. Several ongoing clinical trials are assessing combination chemotherapy and targeted therapy.-
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/21382149en
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshCystectomy-
dc.subject.meshFemale-
dc.subject.meshHigh-Intensity Focused Ultrasound Ablation-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProstatectomy-
dc.subject.meshProstatic Neoplasms-
dc.subject.meshRandomized Controlled Trials as Topic-
dc.subject.meshTreatment Outcome-
dc.subject.meshUrinary Bladder Neoplasms-
dc.subject.meshWatchful Waiting-
dc.titleMaximizing outcomes in genitourinary cancers across the treatment continuum.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Mater Misericordiae Hospital and University College Dublin, Dublin, Ireland.en
dc.identifier.journalBJU internationalen
dc.description.provinceLeinster-

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