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Removing the entire prostate gland and seminal vesicles for localised prostate cancer, now almost always with a robot.
One of three options for localised disease alongside radiotherapy and active surveillance; ProtecT showed identical 15-year prostate cancer mortality (~3%) across all three. Robot-assisted laparoscopic prostatectomy dominates in high-income countries with nerve-sparing techniques to reduce erectile dysfunction, but incontinence (5-20%) and impotence (30-70%) remain the main harms. PSA should become undetectable; a rise afterwards (biochemical recurrence) is imaged with PSMA PET and treated with salvage radiotherapy.
Showing the technology this term belongs to: Robotic & minimally invasive surgery.
The limit of what a prostate scan can be asked to do. It is a good triage test for whether to biopsy and a poor map of where every tumour is, which matters for anyone being offered treatment to part of the gland or follow-up by imaging alone.
The clearest evidence that radical treatment of localised prostate cancer saves lives when the cancer was found clinically rather than by a blood test, and the clearest single statement of what grade does: a Gleason score above 7 carried ten times the risk of death of a score of 6 or lower in the same trial.
The trial that made observation a defensible choice for low-risk prostate cancer found by a blood test, and that supplied the number a man needs when weighing surgery: the progression it prevents is mostly progression on a scan or a blood test, and the harms it causes are felt every day.
The origin of the blood test that defines how prostate cancer is found, monitored and declared to have recurred. Its strength was always monitoring a known cancer; the problems began when the same test was used to look for cancer in men who had no symptoms.
Shares Extraprostatic extension and seminal vesicle invasion, EORTC 22911, RAVES (TROG 08.03/ANZUP), SWOG 8794.
Shares RAVES (TROG 08.03/ANZUP), SWOG 8794, ARTISTIC meta-analysis, GETUG-AFU 16.
Shares Extraprostatic extension and seminal vesicle invasion, EORTC 22911, RAVES (TROG 08.03/ANZUP), SWOG 8794.
Shares Extraprostatic extension and seminal vesicle invasion, EORTC 22911, RAVES (TROG 08.03/ANZUP), SPCG-4 (Scandinavian Prostate Cancer Group Study 4).
Shares PIVOT (Prostate Cancer Intervention Versus Observation Trial), SPCG-4 (Scandinavian Prostate Cancer Group Study 4), Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate, Choosing treatment for localised prostate cancer: what each option costs.
Shares PIVOT (Prostate Cancer Intervention Versus Observation Trial), SPCG-4 (Scandinavian Prostate Cancer Group Study 4), Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate, Choosing treatment for localised prostate cancer: what each option costs.
Shares PIVOT (Prostate Cancer Intervention Versus Observation Trial), SPCG-4 (Scandinavian Prostate Cancer Group Study 4), Choosing treatment for localised prostate cancer: what each option costs, ProtecT.
Shares Whole-mount pathology, Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging, Publish a per-lesion miss rate for every prostate MRI service before it is allowed to guide focal treatment, Gleason score / Grade Group.