Prostate cancer Multidisciplinary approach: a key to success.

摘要

Diagnosis and treatment of prostate cancer has improved in the last few years, in part due to a multidisciplinary approach between urologists, oncologists, radiotherapists, radiologists, pathologists, basic and translational researchers for a successful management. The TAX 327 study is the paradigm of a smooth communication between expert physicians that led to the approval of docetaxel in metastatic hormone-resistant prostate cancer (HRPC). Survival benefit with docetaxel in HRPC was confirmed in an updated survival analysis reported this year. A nomogram to predict survival in metastatic HRPC treated with chemotherapy was established based on the TAX 327 study. Unfortunately in early prostate cancer, some of the phase III clinical trials with chemotherapy had to be closed due to lack of sufficient accrual, due to, at least in part, an unsuccessful collaboration between urologists, medical oncologists and radiotherapists. In earlier phases of prostate cancer, a successful multidisciplinary approach has led to important advances in genomics, biomarkers and imaging techniques that have created big excitement for future improvements in the management of prostate cancer. An example is the validation of novel molecular diagnosis tests such as PCA3 or TMPRSS2 - ETS in urinary samples. Importantly, we should not forget that the key for a successful future development in the management of prostate cancer will require the expertise of all disciplines to provide optimal care.