Management of Biochemical Recurrence of Prostate Cancer After Curative Treatment: A Focus on Older Patients.
Journal
Drugs & aging
ISSN: 1179-1969
Titre abrégé: Drugs Aging
Pays: New Zealand
ID NLM: 9102074
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
accepted:
01
08
2022
pubmed:
26
8
2022
medline:
14
9
2022
entrez:
25
8
2022
Statut:
ppublish
Résumé
Following a treatment with curative intent, a biochemical recurrence may be diagnosed, often many years after the primary treatment. The consequences of this relapse on survival are very heterogeneous. The expected specific survival at relapse is above 50% at 10 years. Therefore, its management needs to be balanced with the individual life expectancy. The relapse needs to be categorized as either a low- or high-risk category. The latter has to be considered for salvage therapy, provided the individual life expectancy is long enough. It is evaluated through an initial geriatric assessment, starting with the G8 score as well as the mini-Cog. A comprehensive geriatric assessment might be needed based on the G8 score. Patients will then be categorized as either fit, vulnerable, or frail. If a local salvage therapy is considered, the relapse localization might be of interest in some situations. Available salvage therapies in senior adults have nothing special compared to salvage of younger men, except for aggressive local therapy, which might be less well tolerated. The key objective in managing a biochemical recurrence in senior adults is to find the right balance between under- and over-treatment in a shared decision process. In many frail and vulnerable men, a clinically oriented watchful waiting should be preferred, while fit men with an aggressive relapse and a significant life expectancy need an active therapy.
Identifiants
pubmed: 36008748
doi: 10.1007/s40266-022-00973-8
pii: 10.1007/s40266-022-00973-8
doi:
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
685-694Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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