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    Adjuvant and salvage treatment after radical prostatectomy: current practice in the UK.

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    Authors
    Lee, Lip W
    Clarke, Noel W
    Ramani, Vijay A C
    Cowan, Richard A
    Wylie, James P
    Logue, John P
    Affiliation
    Clinical Oncology, Christie Hospital, Manchester, UK.
    Issue Date
    2005
    
    Metadata
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    Abstract
    OBJECTIVE: To survey UK urologists and radiation oncologists in the evaluation and treatment of localised prostate cancer in the adjuvant and salvage setting. METHODS: Postal questionnaires were mailed to 292 urologists and 98 radiation oncologists in the UK. RESULTS: In all, 188 (48%) questionnaires were returned. In total, 72/128 (56%) of the urologist respondents and 58/60 (97%) of the oncologist respondents perform routine radical prostate treatment. Among 43 (60%) of the urologist, 40 (69%) recommended adjuvant treatment, which could be radiotherapy, hormonal treatment or combined hormonal and radiation treatment. There is no significant difference between the modality of treatment recommended. The poor prognostic factors that would influence the decision to offer adjuvant treatment include a detectable postoperative PSA, seminal vesicle involvement, positive margins, Gleason score>8 and pathological T3. With regard to the choice of hormonal treatment, most urologists preferred antiandrogens, whereas most oncologists prefer lutienising hormone releasing hormone (LHRH) analogue (P=0.03). Regarding salvage treatment, there is a wide variation in the PSA threshold and number of PSA rises before initiation of investigations and treatment. Significantly more urologists recommended salvage radiotherapy (P=0.02), whereas oncologists recommended combined hormonal radiation therapy (P=0.03). There is a wide variation of practice regarding the duration of hormonal treatment, the type of investigations initiated, range of radiotherapy doses and treatment volumes. CONCLUSION: There is a wide variation in practice among UK clinicians.
    Citation
    Adjuvant and salvage treatment after radical prostatectomy: current practice in the UK. 2005, 8 (3):229-34 Prostate Cancer Prostatic Dis.
    Journal
    Prostate Cancer and Prostatic Diseases
    URI
    http://hdl.handle.net/10541/75879
    DOI
    10.1038/sj.pcan.4500816
    PubMed ID
    15999120
    Type
    Article
    Language
    en
    ISSN
    1365-7852
    ae974a485f413a2113503eed53cd6c53
    10.1038/sj.pcan.4500816
    Scopus Count
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