The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information

Updated statistics with estimated new cases and deaths for 2009 (cited American Cancer Society as reference 1).

Added text about one independently validated nomogram that demonstrated increased accuracy in predicting biochemical recurrence-free survival (cited Shariat et al. as reference 32 and Kattan et al. as reference 33).

Treatment Option Overview

Added text about the interest shown in the use of novel radiation techniques for the treatment of prostate cancer.

Added text about men with screen-detected prostate cancer who are candidates for active surveillance and with definitive therapy reserved for signs of tumor progression; the specific criteria for active surveillance; and the subsequent median follow-up data (cited van den Bergh et al. as reference 27 and level of evidence 3iiB).

Added text about a Swedish trial conducted in the pre-screening era in which radical prostatectomy was compared to watchful waiting in men with early-stage disease (cited Holmberg et al. as reference 34 and Bill-Axelson et al. as reference 35 and level of evidence 1iiA). Also added image about the Scandinavian Prostate Cancer Group-4 (SPCG-4) study.

Added text about a post hoc subset analysis that showed a significant difference in overall mortality favoring prostatectomy for men aged 65 years and younger and the contrasting data for men aged 65 years or older. Also added image about the SPCG-4 study's cumulative incidence graphs.

Added text about the ongoing Prostate Intervention Versus Observation Trial that is comparing radical prostatectomy with watchful waiting, using overall mortality as its primary endpoint.

Added Sanda et al. as reference 37.

Added text about the carcinogenic risk of radiation (cited Nieder et al. as reference 60).

Stage I Prostate Cancer

Added Blana et al. as reference 29, Ficarra et al. as reference 30, and Eastham as reference 31.

Stage II Prostate Cancer

Added text about a Swedish trial conducted in the pre-screening era in which radical prostatectomy was compared to watchful waiting in men with early-stage disease (cited Holmberg et al. as reference 1 and Bill-Axelson et al. as reference 2 and level of evidence 1iiA). Also added image about the Scandinavian Prostate Cancer Group-4 (SPCG-4) study.

Added text about a post hoc subset analysis that showed a significant difference in overall mortality favoring prostatectomy for men aged 65 years and younger and the contrasting data for men aged 65 years or older. Also added image about the SPCG-4 study's cumulative incidence graphs.

Added text about the ongoing Prostate Intervention Versus Observation Trial that is comparing radical prostatectomy with watchful waiting, using overall mortality as its primary endpoint.

Added text about trials studying the role of postprostatectomy adjuvant radiation therapy because 40% to 50% of men with clinically organ-confined disease are found to have pathologic extension beyond the prostate capsule or surgical margins (cited Thompson et al. as reference 17 and level of evidence 1iiA).

Added text about a randomized trial of men with locally advanced nonmetastatic prostate cancer who received an LHRH-agonist plus long-term flutamide with or without external-beam radiation therapy (cited Widmark et al. as reference 29 and level of evidence 1iiA).

Added text about how flutamide, not a standard hormonal monotherapy with T2 or T3, when used as a radiation therapy provided a disease-free survival (DFS) or tumor-specific survival advantage when it was applied.

Added text about a Canadian trial that randomly assigned men to different amounts of neoadjuvant androgen deprivation therapy prior to external-beam radiation therapy to a dose of 66 Gy with no difference in overall survial (OS) or DFS at time of median follow-up (cited Crook et al. as reference 33).

Added text to include high-intensity–focused ultrasound (cited Blana et al. as reference 40, Ficarra et al. as reference 41, and Eastham as reference 42) and other clinical trials as treatment options under clinical evaluation.

Added Horwitz et al. as reference 52.

Added text to treatment options under clinical evaluation to include high-intensity–focused ultrasound; proton-beam radiation therapy; and other clinical trials, including trials of neoadjuvant hormonal therapy followed by radical prostatectomy (cited Fair et al. as reference 58 and Soloway et al. as reference 59).

Stage III Prostate Cancer

Added text about the finding that radiation therapy plus 28 months of androgen deprivation resulted in longer 10-year disease-specific survival but not OS (cited Horwitz et al. as reference 14).

Added text about a randomized trial of men with locally advanced nonmetatatic prostate cancer who received an LHRH-agonist plus long-term flutamide with or without external-beam radiation therapy (cited Widmark et al. as reference 32 and level of evidence 1iiA).

Added text about how flutamide, not a standard hormonal monotherapy with T2 or T3, when used as a radiation therapy provided a DFS or tumor-specific survival advantage when flutamide was applied.

Added text to include statistical data from a median follow-up of radical prostatectomy, with or without pelvic lymphadenectomy that indicated that OS was better in the radiation arm (cited Thompson et al. as reference 35 and level of evidence 1iiA).

Recurrent Prostate Cancer

Added Trock et al. as reference 1.

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