期刊
ONKOLOGIE
卷 28, 期 6-7, 页码 361-366出版社
KARGER
DOI: 10.1159/000085661
关键词
prostate cancer; relapse, biochemical; PSA doubling time; prognostic factors
类别
Prostate cancer is the most common malignant disease and second in causes of cancer death among men in Western Europe and North America. Despite improved surgical and irradiation techniques tumor relapse after curatively intended therapy is not uncommon. Due to the difficulty in discriminating local and systemic progression, it is often difficult to decide what this means for the patient and what kind of second-line treatment has to be given. Modern imaging techniques (MRI with endorectal coil, Choline-PET- CT, ProstaScint(R)-Scan) are used for diagnosis of prostate cancer relapse. Nevertheless, early detection of local tumor relapse and likewise the detection of disseminated tumor cells often fails. To differentiate between local and systemic progression, prognostic factors of the primary tumor ( grading, surgical margins, infiltration of the seminal vesicles, lymph node metastases) and PSA kinetics are used. The time from initial treatment to biochemical relapse and PSA doubling time are of highest prognostic relevance. Local progression allows second-line local treatment with potentially curative results ( local irradiation after radical prostatectomy, salvage-surgery /cryotherapy /HIFU after irradiation), while in the case of systemic progress a palliative systemic therapy ( hormonal treatment, chemotherapy, bisphosphonates) is indicated. Before deciding on the most appropriate therapy, prognostic factors and the patient's individual situation ( co-morbidity, life expectancy, individual wishes) should be taken into account.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据