Himu Lukka

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 26-29, 2002

Abstract The Genito-Urinary Radiation Oncologists of Canada (GUROC) have produced a consensus statement on radiotherapy in prostate cancer. This paper summarizes the consensus statement with regard to risk grouping and the role of hormones and radiotherapy. Survival is the most important outcome in the assessment of patients treated with radiotherapy. Other outcomes of interest include disease­free survival, metastatic-free survival, local control, biochemical measures, toxicity, efficacy, and quality of life. Risk groupings based on prognostic data are increasingly used in the management of prostate cancer. These groupings have been correlated to prognosis in several studies, and are… More >

D. Scott Ernst

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 21-25, 2002

Abstract The development of hormone resistance is an unfortunate final common pathway in most patients with advanced prostate cancer, resulting in a narrowing of therapeutic options for the clinician, and limited median survival of 10-12 months for the patient. While cytotoxic chemotherapy has been utilized for many years, its efficacy has been disappointing. Quality of life assessments are increasingly used in assessing response in hormone­resistant prostate cancer (HRPC), and PSA has emerged as an important surrogate marker of response in both local and advanced disease. Estramustine and the taxanes have been investigated, as monotherapy and in More >

Armen G. Aprikian

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 18-20, 2002

Abstract Clinical outcomes in patients with localized prostate cancers are heterogeneous. In recent years, analyses of large datasets from multiple centres have yielded a better understanding of how to measure risk in localized prostate cancer. Regardless of whether patients are treated with prostatectomy, radiotherapy, brachytherapy, or expectant management, three factors appear correlated with clinical outcome: biopsy Gleason score, clinical T stage, and serum prostate-specific antigen (PSA). Partin Tables, derived from these parameters and recently updated and refined, may be used to estimate the risk of metastasis and to assess certain aspects of surgical management in clinically… More >

Michael A.S. Jewett

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 14-17, 2002

Abstract In 2002, open retropubic radical prostatectomy remains the standard of care for localized carcinoma of the prostate. However, the laparoscopic approach offers several appealing advantages and is being practiced more widely. The more commonly performed technique is the transperitoneal "Montsouris" technique with defined steps which are described. There are a number of pointers that are learned with experience. The most remarkable aspect of laparoscopic prostatectomy is the relatively pain­free and trouble-free postoperative course. Patients can be discharged within 2 days, have very little analgesic requirement, and feel well faster. The catheter can be removed in… More >

Yves Fradet

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 8-13, 2002

Abstract Many methods exist to define high-risk prostate cancer. These include clinical stage, serum PSA, and pathological features such as Gleason score and the number of positive biopsies. Partin tables are widely used to stratify patients according to risk of adverse pathological features at surgery, and to identify those more likely to remain free of recurrent disease following surgery. The priority in most patients with localized prostate cancer remains the selection of a treatment that will provide them with the best chance for cure. While treatment-related morbidity is an important issue, we believe that side effects… More >

Laurence H. Klotz, Richard Choo, Gerard Morton, Cyril Danjoux

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 2-7, 2002

Abstract The optimal management of clinically localized prostate cancer remains unresolved. Management options range from a conservative approach to definitive treatment. While evidence suggests that expectant management yields similar 10-year survival rates and quality-adjusted life years compared to definitive treatment, this approach alone will deprive some patients with potentially curable disease of the opportunity for curative therapy. Effective management of localized prostate cancer requires differentiation between patients with biologically aggressive disease, in whom curative therapy is strongly warranted, and those with indolent malignancy, in whom conservative management would be equally efficacious. A comparison of surveillance studies… More >

Roanne Segal¹, Eric Winquist², Himu Lukka³, Joseph L. Chin⁴, Michael Brundage⁵, B. R. Markman⁶

Canadian Journal of Urology, Vol.9, No.5, pp. 1625-1633, 2002

Abstract Background and purpose: To examine the role of adjuvant chemotherapy in the treatment of patients with deep muscle-invasive transitional cell carcinoma (TCC) of the bladder who have undergone cystectomy.
Materials and methods: A systematic review of the published literature was combined with a consensus process, involving the interpretation of evidence within the context of conventional practice, to develop an evidence-based practice guideline for use in Ontario.
Results: Five randomized controlled trials (RCTs) comparing adjuvant chemotherapy with observation were found that reported data on survival. Sample sizes of the trials were small, and each of the trials evaluated a cisplatin-based… More >

Laurence H. Klotz

Canadian Journal of Urology, Vol.9, No.5, pp. 1623-1623, 2002

Abstract This article has no abstract. More >

Darrel E. Drachenberg¹, David G. Bell²

Canadian Journal of Urology, Vol.9, No.4, pp. 1602-1606, 2002

Abstract Background: The treatment of localized prostate cancer has increased over the past decade in large part due to enhanced screening efforts with prostate specific antigen (PSA) and has resulted in a dramatic increase in the number of radical retropubic prostatectomies being performed in recent years. It is estimated that between 5% and 10% of men who are candidates for radical surgical treatment for localized prostate cancer will have concomitant inguinal hernia. Given the well described complications of untreated inguinal hernias we propose that simultaneous repair be undertaken along with radical retropubic prostatectomy for preoperatively defined hernias More >

Marc David¹, Luis Souhami¹, Armen Aprikian²

Canadian Journal of Urology, Vol.9, No.4, pp. 1599-1601, 2002

Abstract A case of post renal acute renal failure secondary to radiation therapy for prostate cancer is described. Severe bladder inflammatory reaction, leading to bilateral ureteric obstruction, occurred after a moderate dose of radiotherapy (6400 cGy in 35 fractions). At a follow-up time of 8 years, the patient has fully recovered and remains disease-free. To our knowledge, this complication has never been described previously. Given the thrust in prostate cancer treatment toward dose escalation this complication could become more frequent. More >