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Update on Prostatectomy Versus Observation Trials

Gerald L. Andriole, MD, who served on the cause of death ascertainment committee for the Prostate Intervention Versus Observation Trials (PIVOT), discusses PIVOT and criticisms to the trial design. Additionally, he analyzes similar trials testing definitive versus non-definitive treatment in low-risk disease.

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Changing Distribution, Size and Grade of Prostate Cancer: Whole-Mount Prostatectomy Analysis

M. Scott Lucia, MD, summarizes the changes in the clinical management of prostate cancer since 1990, specifically regarding PSA screening, active surveillance, targeted focal therapy, and pathology grading practices. Also, he analyzes whole-mount prostatectomy data from the past 16 years that has shown increasingly higher grade and volume tumors. He then discusses whether or not this is exclusively due to patient selection and over-grading.

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Should MRI Be Used to Monitor for AS? Pro Argument

Peter A. Pinto, MD, argues that MRI can help select prostate cancer patients for active surveillance (AS). While MRI has some limitations, with proper application, it can reduce patient and urologist anxiety, repeat biopsies, and amount of cores taken during AS. Subsequently, this will reduce morbidity, bleeding, erectile dysfunction, and infections related to biopses.

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