Christopher J. Kane, MD, FACS presented “Point-Counterpoint: Surgery vs. Brachytherapy for Intermediate and High-Risk Prostate Cancer – Surgery” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Kane, Christopher J. “Point-Counterpoint: Surgery vs. Brachytherapy for Intermediate and High-Risk Prostate Cancer – Surgery.” March 10, 2023. Accessed Nov 2024. https://grandroundsinurology.com/point-counterpoint-surgery-vs-brachytherapy-for-intermediate-and-high-risk-prostate-cancer-surgery/
Point-Counterpoint: Surgery vs. Brachytherapy for Intermediate and High-Risk Prostate Cancer – Surgery – Summary
Christopher J. Kane, MD, FACS, delivers an insightful presentation on the topic of surgery versus brachytherapy for intermediate and high-risk prostate cancer. He begins by highlighting the importance of accurately defining high-risk disease and its implications for treatment outcomes.
While various definitions exist, Dr. Kane focuses primarily on high-risk disease characterized by a PSA over 20, Gleason sum of eight, and clinical stage T2C. Dr. Kane presents his viewpoint that surgery is the optimal treatment for well-selected patients with high-risk prostate cancer. He supports this assertion by discussing several key advantages of surgery over radiation therapy.
He emphasizes the benefits of improved pathologic staging and risk assessment that surgery offers. Additionally, he notes the effectiveness of adjuvant and early salvage therapy in curing many adverse pathologic patients. Moreover, surgery provides better local control and reduces the likelihood of ureteral obstructions and urinary procedures at progression.
Dr. Kane then presents comparative risk-adjusted mortality data from various studies. These analyses demonstrate that surgery significantly reduces cause-specific mortality compared to all forms of radiation therapy. The magnitude of the differences increases with disease risk, further underscoring the value of surgery for patients with higher-risk disease.
This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Surgery vs. Brachytherapy for Intermediate and High-Risk Prostate Cancer – Brachytherapy.“
About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Christopher J. Kane, MD, FACS, is Dean of Clinical Affairs at the University of California (UC), San Diego School of Medicine. He is also Chief Executive Officer (CEO) of UC San Diego Health Physician Group and Professor of Urology at UC San Diego Health. Dr. Kane is on the Executive Governing Board of UC San Diego Health Sciences and the Executive Committee of UC San Diego’s Clinical Integration Network. In addition, he is the president of the Western Section American Urological Association (AUA) and trustee of the American Board of Urology (ABU).
Dr. Kane is an internationally recognized expert in prostate cancer and kidney cancer epidemiology, risk stratification, and outcomes after treatment. He completed his urology residency at Oakland Naval Hospital and UC San Francisco. Dr. Kane earned his medical degree at Uniformed Services University in Bethesda, Maryland, and his BS degree in mechanical engineering at UC Davis. From 2009 to 2016, he was Co-Chair of the Renal Cell Carcinoma Advisory Task Force, National Cancer Institute. Dr. Kane is on the AUA guidelines in prostate cancer committee and was elected to the American Association of Genitourinary Surgeons (AAGUS) in 2014. In 2017 Dr. Kane was elected to the Clinical Society of Genitourinary Surgeons (GSGUS). He was selected as a “Top Doctor” in San Diego in 2008-2022. In 2010, he was selected as one of two Physician Healthcare Champions in San Diego by the San Diego Business Journal and was awarded the Distinguished Engineering Alumni Medal by UC Davis in 2011. Dr. Kane is a retired Navy Captain and a decorated veteran of Desert Storm. He has authored over 370 publications and book chapters, primarily on prostate cancer risk factors and outcomes, prostate cancer surgery, and minimally invasive surgery for prostate and kidney cancer.
