Background Flashcards
In which portion of the prostate is ECE most commonly found?
ECE is most commonly found in the poseterolateral portion of the prostate, near the prostatic neurovascular bundle.
What is the ASTRO/American Urological Association (AUA) definition of biochemical recurrence s/p radical prostatectomy?
The AUA definition of biochemical recurrence s/p radical prostatectomy is a serum PSA ≥0.2 ng/mL, confirmed by a 2nd determination also ≥0.2 ng/mL.
What is the mean time to PSA nadir after RT for localized prostate cancer?
The mean time to PSA nadir after RT for localized prostate cancer is 18 mos. Though there are contradictory reports, it seems that the rate of decline in PSA does not appear to correlate with risk of Dz recurrence.
What is the Phoenix criterion (2005 consensus panel) for defining biochemical recurrence after RT for localized prostate cancer?
Partly to eliminate concerns about the “backdating” associated with the original ASTRO definition, the Phoenix criterion for defining biochemical recurrence after RT for localized prostate cancer is a PSA rise of ≥2 ng/mL above the PSA nadir, even after the discontinuation of androgen deprivation therapy (ADT). The date of recurrence is the date of the PSA that triggers the definition.
What is the concept of “PSA bounce” in pts who rcvd RT for localized prostate cancer? How should it be managed?
After RT for localized prostate cancer, serum PSA typically falls. However, it can rise transiently, called a PSA bounce, usually around 12–18 mos after Tx, and classically associated with pts having undergone brachytherapy. This can occur even without Dz recurrence. Using the Phoenix definition of biochemical failure, a PSA bounce can trigger a false failure in 10%–20% of pts. There is no definitive method to distinguish a PSA bounce from recurrent Dz. The PSA should be rechecked 3–6 mos later and managed accordingly.
What is the risk of mets or death following biochemical failure after prostatectomy?
In a prominent series of men who developed biochemical failure post prostatectomy and did not undergo subsequent salvage Tx, the median MFS was 10 yrs. (Pound, JAMA 1999)
