Multifocal high-grade prostatic intraepithelial neoplasia is still a significant risk factor for adenocarcinoma

Imaging Recommendations for Diagnosis, Staging, and Management of Prostate Cancer

The Prostate Carcinoma Guidelines Panel have formulated these guidelines to assist medical professionals in the evidence-based management of prostate cancer. These have been formulated by a panel consisting of Indian multidisciplinary group of radiologists, uro-oncologists, urologists, radiation oncologists, medical oncologists, and pathologists. These recommendations present the best evidence available to the clinicians; however, using these recommendations will not always result in the best outcome. They aid in decision making for individual patients; however, these will never replace clinical expertise when making treatment decisions. Taking personal values and preferences or individual circumstances of patients into account is necessary for final treatment decision. Guidelines are not mandatory and should not to be referred as a legal standard of care.

Outcomes of treatment in men with prostate cancer at the cancer centre Bahamas

PURPOSE

This is a first report from The Bahamas of management and long-term outcomes in men with non-metastatic prostate cancer treated with radiotherapy, with or without androgen deprivation therapy, from 2004 to 2016.

METHODS

Patients were characterized by baseline factors, stratified by risk groups using tumor stage (clinical T-stage), prostate-specific antigen (PSA) test result and Gleason grade, and sorted by treatment combinations (by radiation volume and use of androgen deprivation).

RESULTS

Overall, 205/216 men were Afro-Caribbean. Median age was 66. There were 18 low-, 77 intermediate-, and 121 high-risk patients, treated with prostate-only versus pelvis plus prostate radiotherapy, many receiving 2 years of androgen suppression. Time to commence radiation was about 6 months from initial diagnosis. In those not relapsing, global PSA nadir was reached in 4 years and was under 1.0, reduced from a mean at baseline of 31. At 10 years, disease-free experience (32 relapses) was 68% and overall survival was 87%, although only 2/12 deaths were related to prostate cancer. This experience compares favorably with recently published outcomes from other countries using very similar treatments.

CONCLUSIONS

This study establishes benchmark statistics from diagnosis to long-term follow-up. Outcomes in Bahamian men are consistent with expectations from risk-stratified guidelines followed in developed countries.