What’s being presented at the AUA in May: Part III

In the “Outstanding Posters” sessions at the annual meeting of the American Urological Association meeting upcoming in Orlando, there are several posters that deal specifically with prostate cancer-related issues.

From the session on “Outstanding Posters: Oncology“, we have already discussed the poster by Schroeck et al. (abstract no. OP3-02) in a dedicated blog post. Other posters in this session that are worth noting are:

  • A poster by Welty et al. (abstract no. OP3-03) that provides an update on data from the UCSF series of > 1,100 active surveillance patients, of whom 764 are formally enrolled in the research protocol. Average (median) follow-up in this series of men is now 57 months and there have been no cases of prostate cancer-specific mortality (despite the fact that 244/764 patients or 32 percent did not actually meet formal criteria for active surveillance). At 5 years post-diagnosis, just over half the patients were progression-free and 40 percent had elected to receive local therapy.
  • A poster by Shakir et al. (abstract no. OP3-04) from Peter Pinto’s group at the National Institutes of Health that looks at the performance of MRI/TRUS fusion-guided biopsy in the detection of prostate cancer in patients within a pre-established range of PSA cut-points. The goal of the research was to better define an optimized patient population for the application of  MRI/TRUS fusion-guided biopsy (as compared to standard, 12-core, systematic, TRUS-guided biopsy). The study results seem to imply that intent is a critical factor since MRI/TRUS fusion-guided biopsy can be used with benefit to either rule out the presence of previously unidentified lesions or to find such lesions. On the basis of such findings one might either recommend expectant management or clearly identify tumors that should probably be treated.
  • A poster by Gandaglia et al. (abstract no. OP3-06) provides data on the relationship between time to biochemical recurrence and risk for prostate cancer-specific mortality based on data from a multi-institutional cohort of 2,065 patients treated for high-risk, localized prostate cancer by radical prostatectomy. The authors conclude that time from surgery to biochemical recurrence is an independent predictor of prostate cancer-specific mortality this group of patients. They further note that men with biochemical recurrence within 3 years may benefit from more aggressive, multi-modal treatments, whereas men with later biochemical recurrence should be considered at low-risk of subsequent prostate cancer-specific mortality.
  • A poster by Crouzet et al. (abstract no. OP3-12) has attempted to compare the outcomes of treatment with radical prostatectomy compared to high-intensity focused ultrasound (HIFU) using a matched pair comparative analysis. These types of comparison are statistical comparisons as opposed to trial-based comparisons, so they need to be interpreted with care. The primary results of the study reported by the authors were as follows: (a) The 7-year salvage external beam radiotherapy-free survival rate was lower after HIFU (62 percent) than after radical prostatectomy (78 percent), and this difference was statistically significant (p = 0.001). (b) The palliative androgen deprivation-free rate at 9 years was not significantly different between HIFU (86 percent) and surgery (87 percent).

In the session entitled “Outstanding Posters: Research” there were a series of 12 abstracts, but none of these had any relevance to the clinical management of prostate cancer in the near future. Oddly, however, in the session entitled “Outstanding Posters: Benign Disease” there was one poster addressing the diffusion of minimally invasive radical prostatectomy:

  • This poster by Anderson et al. (abstract no. OP2-04) looked into whether, in fact, during the early adoption of minially invasive forms of radical prostatectomy (in 2003 to 2008), there may have been an increase in risk for complications and side effects of treatment compared to those seen with open surgery. The study seems to show increases in some areas and not in others.

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