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Categorie di rischio: punto di vista dell’urologo

Categorie di rischio: punto di vista dell’urologo. Alessandro Giacobbe Ospedale “San Giovanni Bosco” S.C. Urologia Torino. “Advanced” PCa. Treatment Options. Surgery RT Cryo/Other Multimodal Approach. Treatment Options. Surgery RT Cryo / Other Multimodal Approach.

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Categorie di rischio: punto di vista dell’urologo

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  1. Categorie di rischio: punto di vista dell’urologo Alessandro Giacobbe Ospedale “San Giovanni Bosco” S.C. Urologia Torino

  2. “Advanced” PCa

  3. Treatment Options • Surgery • RT • Cryo/Other • Multimodal Approach

  4. Treatment Options • Surgery • RT • Cryo/Other • MultimodalApproach

  5. 10-yr PCSM >80%

  6. 15-yr Radical Prostatectomy CancerSpecificMortality Gleason score≤6 15-yr Cancer specific Survival ≥99% Gleason score 7(3+4) 15-yr Cancer specific Survival 98% Gleason score 7(4+3) 15-yr Cancer specific Survival 94% Gleason score 8-10 15-yr Cancer specific Survival 65%

  7. 15-yr Radical Prostatectomy Cancer Specific Mortality Gleason score≤6 15-yr Cancer specific Survival ≥99% Gleason score 7(3+4) 15-yr Cancer specific Survival 98% Gleason score 7(4+3) 15-yr Cancer specific Survival 94% Gleason score 8-10 15-yr Cancer specific Survival 65%

  8. Locally Advanced CaP Gerber, G.S., et al.. Eur Urol, 1997. 32: 385 Hsu, C.Y., et al. Eur Urol, 2007. 51: 121 Joniau, S., et al. Eur Urol, 2015. 67: 319 Xylinas, E., et al. BJU Int, 2009. 103: 1173

  9. Locally Advanced CaP Gerber, G.S., et al.. Eur Urol, 1997. 32: 385 Hsu, C.Y., et al. Eur Urol, 2007. 51: 121 Joniau, S., et al. Eur Urol, 2015. 67: 319 Xylinas, E., et al. BJU Int, 2009. 103: 1173

  10. Locally Advanced CaP Gerber, G.S., et al.. Eur Urol, 1997. 32: 385 Hsu, C.Y., et al. Eur Urol, 2007. 51: 121 Joniau, S., et al. Eur Urol, 2015. 67: 319 Xylinas, E., et al. BJU Int, 2009. 103: 1173

  11. Treatment Options • Surgery • RT • Cryo/Other • MultimodalApproach

  12. 2.5 fold increased risk of metastasis

  13. Treatment Options • Surgery • RT • Cryo/Other • MultimodalApproach

  14. Treatment Options • Surgery • RT • Cryo/Other • MultimodalApproach

  15. Adjuvant RT recommended for pT3 pts

  16. OurClinicalPractice • Age <70, Gleason ≤ 6, PSA < 10 • Nervesparingprostatectomy • ActiveSurveillance (1-2 poscore/12 or more) • Gleason score 7 or PSA >10 • Age <70 RadProstatectomy and PLND • Age >70 Radiotherapy • Gleason score ≥8 • Surgery + Radiotherapy + ADT (intermittent)

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