%0 Journal Article
%T What¡¯s new in prostate cancer research?
%J Archive of "Canadian Urological Association Journal".
%D 2016
%R 10.5489/cuaj.3914
%X The preoperative D¡¯Amico system classifies T1c prostate cancer into three risk groups based on their prostate-specific antigen (PSA) values: less than 10 ng/mL, 10.1¨C20 ng/mL, and higher than 20.1 ng/mL, corresponding to low-, intermediate- and high-risk disease categories, respectively.1 However, prognosis can vary widely among men who fall into the intermediate-risk category and additional stratification of this heterogeneous group could aid in optimizing management of this population. A new sub-classification was recently proposed, whereby ¡°unfavourable intermediate-risk¡± (UIR) prostate cancer was defined as any intermediate-risk prostate cancer with a primary Gleason pattern of 4, a percentage of positive biopsy cores higher than 50%, or more than one intermediate risk factor (cT2b¨Cc, PSA 10¨C20 ng/mL or Gleason score 7). 2 A validation study for this new sub-classification system was presented at the EAU 2016. The multicentre study enrolled 4028 patients with intermediate-risk prostate cancer who had been treated by radical prostatectomy between 2000 and 2011.3 After a median followup of 44.4 months, patients with UIR had poorer PSA recurrence-free survival than those without UIR (68.8% vs. 83.5%; hazard ratio [HR] 2.05 [95% CI 1.78¨C2.36]; p=0.0193) (Fig. 1). Men in the UIR group also had a significantly higher need for adjuvant therapy. This common-sense approach to stratifying men with intermediate-risk prostate cancer was seen as reasonable by Canadian urologists attending the session; however, it was suggested that more robust predictions would likely be gained through the use of more fluid nomograms
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083174/