can we talk about urorad?

[Burt Radnolds]

Yes, there is retrospective data that does not attempt to (or does not adequately) control for co-morbidities that shows patients undergoing RP live longer.

That may be the 'critical review' standard for urologists citing literature, but every Rad Onc knows who is more likely to get a RP and who is more likely to get ADT+RT out of a high-risk prostate cancer population, and how that influences survival much more than the choice of treatment modality does.

Yeah I wasn't saying I agree with them by any stretch, just that RP for high risk disease isn't necessarily absurd. If I was 50 with low volume low psa organ confined Gleason 8 disease, I would seriously consider surgery.

---

Members don't see this ad.

 

[medgator]

Yeah I wasn't saying I agree with them by any stretch, just that RP for high risk disease isn't necessarily absurd. If I was 50 with low volume low psa organ confined Gleason 8 disease, I would seriously consider surgery.

yup, the argument I've heard from aggressive GU's is that they would plan for tumor "debulking" with an RRP and follow it up with salvage XRT to eradicate residual disease combined with ADT (maybe even a little taxotere for good measure).

There is no data to support that, but if I was a 40 y/o with confined G9 disease I'd consider it.

Still 100000x better than doing upfront cryo/HIFU to anyone with prostate CA.

 

[OTN]

I’d be curious to see RP + planned adjuvant HT + RT data for high risk disease

 

[w00tz]

I’d be curious to see RP + planned adjuvant HT + RT data for high risk disease

I would be interested as well.

RP alone +/- adjuvant XRT if indicated vs
XRT + ADT vs
RP + ADT + XRT vs
RP + ADT

My guess for bRFS would be RP alone < XRT + ADT < RP + ADT < RP + ADT + XRT
QOL - RP + ADT + XRT < RP + ADT < RP alone < XRT + ADT

 

[Chartreuse Wombat]

I would be interested as well.

RP alone +/- adjuvant XRT if indicated vs
XRT + ADT vs
RP + ADT + XRT vs
RP + ADT

My guess for bRFS would be RP alone < XRT + ADT < RP + ADT < RP + ADT + XRT
QOL - RP + ADT + XRT < RP + ADT < RP alone < XRT + ADT

ClinicalTrials.gov

clinicaltrials.gov

Accrual is slow; I doubt that it will complete accrual. Per PI 300 of 1200 as of a few months ago.

 

[w00tz]

ClinicalTrials.gov

clinicaltrials.gov

Accrual is slow; I doubt that it will complete accrual. Per PI 300 of 1200 as of a few months ago.

Good to know. I was told a trial like this would be difficult to accrue because urologists wouldn't be very interested in enrolling. Similar to why it's been difficult to accrue for SBRT vs lobectomy for early stage lung. Hope the trial does well