Prostate cancer news reports: Saturday, February 20, 2010

In today’s news reports we comment briefly on recent papers that deal with:

  • Radical prostatectomy in men > 75 years of age
  • The impact of anticoagulant therapy on clinical outcomes after radiation therapy
  • The “feasibility” of pre-surgical, docetaxel-based chemotherapy in high-risk patients

Xylinas et al. have reported that laparoscopic radical prostatectomy is “feasible” in men aged between 75 and 81 years of age who have localized prostate cancer, and that the patients have “satisfactory oncological and functional outcomes although the incontinence rate is increased comparing to younger patients.” The “New” Prostate Cancer InfoLink wonders how many of those 22 patients treated would have done just as well without invasive treatment.

Choe et al. have reported new data suggesting that anticoagulant therapy (with warfarin, clopidogrel, or aspirin) may be associated with an improvement in biochemical control at 4 years of follow-up in patients with prostate cancer who received radiotherapy with curative intent. The effect on biochemical recurrence from this retrospective analysis of data from 622 patients was “most prominent” among the patients with high-risk disease. An effect was also evident on risk for distant metastasis.

Garzotto et al. have reported that pre-surgical chemotherapy with docetaxel and mitoxantrone is “feasible” in high-risk patients with localized prostate cancer. However, at a median follow-up of 63 months, nearly half of the high-risk patients in this Phase I/II clinical trial (27/57 or 47.5 percent) had biochemical recurrence. What can not be determined from this study is whether these patients actually did any better than they might have done without the use of chemotherapy. There were clearly significant toxicities associated with this form of treatment, although “Grade 4 toxicities were limited to leukopenia, neutropenia, and hyperglycemia.” (Grade 4 toxic effects of chemotherapy are the highest level of toxicity short of death.)

One Response

  1. Your point [about the Xylinas study] is well taken. It is all about years at risk when considering treatment options in prostate cancer. The study makes the point that the procedure can be done, not necessarily that it should be. As the years at risk, longevity, is small for this group of patients it would be rare that a urologist would recommend surgery and its attendant consequences to this group of patients.

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