Updated PIVOT data seem to support recent AUA/ASTRO/SUO guidelines

A new article in this week’s New England Journal of Medicine has given us follow-up data from the PIVOT trial of radical prostatectomy vs. simple observation in treatment of localized prostate cancer. … READ MORE …

A look back at PIVOT … with additional data for context

Five years ago now, in May 2011, Wilt first presented the results of the PIVOT trial at the annual meeting of the American Urological Association in Washington, DC. A bit over a year later, the final results were published in the New England Journal of Medicine. … READ MORE …

Slow but increasing uptake of observation in initial management of low-risk patients

A new article by Maurice et al. in the Canadian Urological Association Journal provides detailed information about the use of initial observation as a management strategy for low-risk prostate cancer between 2004 and 2011. … READ MORE …

ART or SRT in high-risk patients post-surgery?

As many of our regular readers will know, there is no clear answer to the question whether, among men at elevated risk of progressive disease after first-line surgery, it is better to have adjuvant radiation therapy (ART) within a few months of surgery or to wait until salvage radiation therapy (SRT) is clearly advisable. … READ MORE …

“Observation” in the management of low-risk prostate cancer

In an article in Recent Results in Cancer Research, Wilt argues (yet again)  that “observation” (i.e., something less than active surveillance and perhaps more like “watchful waiting”) is an entirely appropriate way to manage selected men with low-risk prostate cancer. … READ MORE …

Of cost, quality, and care for low-risk prostate cancer

A newly published study in the Annals of Internal Medicine has offered an analysis of the cost-effectiveness of “observation” as compared to immediate initial treatment for men diagnosed with low-risk, localized prostate cancer. … READ MORE …

30 years follow-up of men with initially untreated, localized prostate cancer

A new article in European Urology offers interesting data on the natural history of localized prostate cancer, based on a cohort of 200+ Swedish patients followed for > 30 years. It is important to note immediately that none of these men was originally diagnosed in the PSA era. They all had some form of symptomatic disease at diagnosis. … READ MORE …