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Organo Oficial de la Sociedad Mexicana de Urología

2008, Number 4

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Rev Mex Urol 2008; 68 (4)

Prostate cancer

Álvarez-Blanco MA, Escudero-de los Ríos PM, Hernández-Toríz N

Language: Spanish
References: 87
Page: 245-254
PDF size: 431.87 Kb.


ABSTRACT

Prostate adenocarcinoma is the most common malignant neoplasm in men - more common than lung and colon cancers. In the last five years, localized disease survival was 100% and metastatic disease survival was 33%. Approximately 70% of prostate cancers are diagnosed in men over 65 years of age. Of these cases, about 90% are in the local and/or regional stage. Five-year survival s approximately 100% and general survival calculated at 10 and 15 years is 92% and 61%, respectively. Unlike other countries, prostate cancer mortality has increased in Mexico in the last two decades and presently is the principal cause of death from cancer in adult men. From n etiological viewpoint, prostate cancer is considered to be a multifactorial disease. Current guidelines for early prostate cancer diagnosis are: prostate specific antigen (PSA) determination and digital rectal examination (DRE) after 50 years of age. In patients presenting with an elevated PSA, transrectal biopsy is suggested. The majority of prostate cancers or inate in the peripheral zone of the gland. Histologic grade is closely correlated with the clinical and biological progression of prostate adenocarcinoma. Treatment and prognosis for prostate cancer patients is dependent on cancer stage and time of diagnosis. Today the best candidates for radical prostatectomy are patients with a life expectancy of 10 years or more, who present with a non-palpable tumor with a low or intermediate grade on the Gleason scale that is limited to the prostate. For patients presenting with low-risk early disease, results with external radiotherapy, three-dimensional conformational radiotherapy, brachytherapy or radical prostatectomy have been similar in the majority of series with a followup of 15 years or more. Presently, surgical castration or medical castration with luteinizing hormone releasinghormone (LH-RH) analogues combined with non-steroid antiandrogens such as flutamide and bicalutamide, is the treatment of choice for patients presenting with metastatic disease.


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