Diagnosis and management of advanced hormone-refractory prostate cancer: results of a practice survey on 301 French urologists
Colombel, M.; Davin, J.-L.; Filleul, A.; Rousseau, C.
Progres en Urologie Journal de l'Association Francaise d'Urologie et de la Societe Francaise d'Urologie 14(2): 182-188
2004
ISSN/ISBN: 1166-7087 PMID: 15217132 Document Number: 583737
As no treatment has been demonstrated to prolong survival in hormone-refractory prostate cancer, it was interesting to define the current management of these patients. This survey was designed to identify the criteria used to define hormonal escape, to more clearly define the treatment modalities at this stage of the disease and to evaluate the various therapeutic approaches used. A self-administered questionnaire accompanied by 3 clinical cases was sent by mail to all French urologists registered with the AFU. Three hundred and one (31%) questionnaires were returned. The diagnosis of hormone-refractory cancer was based on the presence of clinical signs or elevated PSA levels in 61% of cases. 65% of urologists reported that they changed treatment as soon as symptoms appeared. The objectives of treatment were improvement of quality of life in 95% of cases and relief of symptoms in 90% of cases. The first-line treatment after hormonal escape is very predominantly (at least 90% of cases) multiple hormonal manipulations. Chemotherapy or referral of patients to an oncologist is performed by more than one third of doctors as second-line treatment (35% of cases) and in almost all cases as third-line treatment (87% of cases). Mitoxantrone-prednisone is the combination chemotherapy most frequently reported in this survey (2 out of 3 doctors). These data illustrate the application by French urologists of the current CCAFU guidelines (Oncology Committee of the French Urology Association) for hormone-refractory prostate cancer.