Oncoforum Urology: Prostate Cancer 2008 at a Glance

ContextMany new findings on prostate cancer (PCa) were presented at the 2008 annual meetings of the European Association of Urology (EAU), the American Urological Association (AUA), the American Society of Clinical Oncology (ASCO), and the American Society for Therapeutic Radiology and Oncology (ASTRO).ObjectiveTo summarise interesting topics on PCa from urological and oncological congresses in 2008.Evidence acquisitionThis manuscript is based on a presentation given at a satellite symposium on PCa held at the 2009 annual meeting of the EAU in Stockholm, Sweden. Data were retrieved from selected abstracts on PCa presented at urological and oncological congresses in 2008.Evidence synthesisThe frequency of lymph node metastases seems low in patients with low-risk PCa and the percentage of positive biopsy cores may be used to predict lymph node involvement. Therefore, the diagnostic benefit of extended pelvic lymphadenectomy is questioned in patients with low-risk PCa undergoing radical prostatectomy. According to two studies presented at the EAU annual meeting, appropriately selected patients with very low-risk PCa might be safely managed by active surveillance. Furthermore, it is still unclear whether the risk of developing secondary malignancies increases after primary radiation of PCa. Confounding factors such as smoking should be taken into consideration before drawing any conclusions. With regard to locally advanced PCa, an update of the Southwest Oncology Group (SWOG) 8794 trial confirmed that adjuvant radiotherapy to radical prostatectomy reduces recurrence. In addition, adjuvant radiotherapy significantly reduced the risk of metastases and improved overall survival in men with pT3 PCa. In patients with castration-resistant PCa, abiraterone acetate seems to be well tolerated and effective.ConclusionsMany interesting new data on PCa were presented at the 2008 oncological and urological congresses. Some may have an impact on clinical practice, whereas other data raise new questions that will have to be answered by further research.