The role of biopsy core number in selecting prostate cancer patients for watchful waiting
November 9th, 2009 Posted in watchful waitingWatchful waiting (WW) entails a strategy by which selected men are managed expectantly with the intention of applying potentially curative treatment in case of signs of progression.
While WW strategy has changed the treatment and management of low-risk prostate cancers, it must also evolve as a diagnostic tool. Indeed, the proportion of patients treated due to upstaging or to prostate-specific antigen (PSA) rising during follow-up is substantial because of a lack of precise initial staging. In this context, the study of selection strategy for AS candidates is essential.
The use of the biopsy diagnostic tool can be improved. The next studies should better identify the subgroup of men who benefit most from extensive biopsy strategies. The prostate volume has to be considered. Another step will probably be to integrate urine prognostic markers, such as prostate cancer gene 3, to better characterize the potential aggressive behaviour of supposed low-risk prostate cancers. The actual importance of prostate biopsies has evolved from pure cancer detection to investigation of how biopsy results can assist clinical management for patients.