title: [Management of a progressing prostate cancer: results of a national study].
abstract: BACKGROUND
  The introduction of new treatments in metastatic castration resistant prostate cancer (mCRPC) requires a close follow-up to detect a progression and then to adapt the treatment. In that context, a national survey was proposed to a group of experts and the aim was to identify the modalities of surveillance in different clinical situations.
  
  
  METHODS
  A questionnaire was sent to 1464 urologists, medical oncologists and radiotherapists, about a clinical case; it was about a patient presenting a prostate cancer, evolving from a biologic progression after radical prostatectomy to a situation of metastasis resistant to the castration. The questionnaire contained ten questions about reasons of changing treatment because of progression, and about modalities of the follow-up.
  
  
  RESULTS
  A total of 318 questionnaires were analyzed (response rate of 22%). The results showed comparable practices between the different types of specialists, even if a more frequent rhythm of surveillance was reported by medical oncologists and radiotherapists. At progression after radical prostatectomy, a clinical and biological surveillance was generally realized every 3 or 6 months, and imaging exams were done on demand. Then, as the cancer progresses, the surveillance became systematic and more and more close, with imaging done every 3 months or on demand. While the definition of progression was essentially based on PSA testing at the beginning of the castration resistance, it then combines different clinical, biological and radiological criteria.
  
  
  CONCLUSIONS
  There are few recommendations available about follow-up of patients with a mCRPC. In that survey, the oncologists and urologists reported a more intensive rhythm of surveillance as the prostate cancer progresses.
  
  
  METHODS
  4.
authors.affiliation: Institut Montsouris, université Paris Descartes, 42, boulevard Jourdan, 75014 Paris, France. Electronic address: francois.rozet@imm.fr.
authors.forename: F
authors.initials: F
authors.lastname: Rozet
authors.affiliation: Hôpital Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Roupret
authors.affiliation: Hôpital St-Louis, université Paris Diderot, 1, avenue Claude-Vellefaux, 75010 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Hennequin
authors.affiliation: Institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Massard
authors.affiliation: Institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
authors.forename: P
authors.initials: P
authors.lastname: Blanchard
authors.affiliation: Institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Le Moulec
mesh_terms: D000368:Aged; D018450:Disease Progression; D005602:France; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D064129:Prostatic Neoplasms, Castration-Resistant / Q000628:therapy*
keywords: Cancer de la prostate; Hormonotherapy; Hormonothérapie; PSA; Prostate cancer; Survie; Survival