Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
Department of Urology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
Eur Urol Focus. 2019 Mar;5(2):155-158. doi: 10.1016/j.euf.2018.12.003. Epub 2018 Dec 23.
Prostate cancer remains a leading cause of cancer-related death in men. Concurrently, the incidence of metastatic hormone-sensitive prostate cancer (mHSPC) at diagnosis has significantly risen as a result, in part, of recent advances in imaging. Given the increased utilization of prostate-specific membrane antigen-targeted positron emission tomography imaging and other modalities with improved accuracy in the detection of cancer, combined with changes in screening and other secular trends, more men get diagnosed at an oligometastatic stage in which timely treatment may improve survival. However, the optimal timing of initiation and the specific sequence of systemic agents are not yet clearly defined. Worldwide, both urologists and oncologists may primarily direct the medical management of mHSPC. This collaboration potentially invites differing treatment recommendations dependent upon the treating physician's medical specialty. Ideally, a shared decision-making approach incorporating multidisciplinary tumor board discussions and personalized analysis will provide personalized treatment recommendations to optimize the benefit for mHSPC patients. Here, we conducted a concise review and evaluation of existing literature, and provide one perspective on health care delivery for mHSPC worldwide. PATIENT SUMMARY: Given the improvement in imaging techniques and changes in screening practices, the incidence of metastatic hormone-sensitive prostate cancer will likely continue to rise. An early, multimodal treatment approach involving a multidisciplinary team is critical to delivering the best care to this patient population.
前列腺癌仍然是男性癌症相关死亡的主要原因。同时，由于影像学技术的近期进展，转移性激素敏感型前列腺癌（mHSPC）的诊断发病率显著上升。鉴于前列腺特异性膜抗原靶向正电子发射断层扫描成像等技术的广泛应用，以及在癌症检测方面准确性的提高，再加上筛查和其他长期趋势的变化，越来越多的男性在寡转移阶段被诊断出癌症，及时治疗可能会提高生存率。然而，目前还没有明确确定开始治疗的最佳时机和系统药物的具体顺序。在全球范围内，泌尿科医生和肿瘤学家都可能主要负责 mHSPC 的医学管理。这种合作可能会根据治疗医生的专业领域不同而提出不同的治疗建议。理想情况下，通过多学科肿瘤委员会讨论和个性化分析，采用共同决策的方法，将为 mHSPC 患者提供个性化的治疗建议，以优化其获益。在这里，我们对现有文献进行了简明的回顾和评估，并就全球范围内 mHSPC 的医疗服务提供了一个视角。患者总结：由于成像技术的改进和筛查实践的改变，转移性激素敏感型前列腺癌的发病率可能会继续上升。早期采用多模式治疗方法，并由多学科团队参与，对于为这一患者群体提供最佳护理至关重要。
