Positive surgical margins: the argument for androgen deprivation and chemotherapy.
Management of patients with positive surgical margins after radical prostatectomy is a complex and debatable issue. It is clear, however, that many of these patients have high-risk disease characteristics. Because of a significant risk of relapse, patients with positive surgical margins and high-risk disease characteristics should be offered the option of participating in clinical trials evaluating the role of adjuvant therapy. A distinction between the concepts of adjuvant versus salvage therapy is made and the rationale for the use of androgen deprivation therapy, chemotherapy, or a combination in the adjuvant setting is discussed in the context of the on-going phase III trials in the United States.
Higano
Celestia S
CS
Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA 98109, USA. garfield@ccf.edu
D000726:Androgen Antagonists / Q000494:pharmacology*; D000728:Androgens / Q000378:metabolism*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery* / Q000628:therapy; D012008:Recurrence; D012306:Risk; D016879:Salvage Therapy
D000726:Androgen Antagonists; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal