Multidisciplinary Symposium — Prostate Cancer

Currently, urological surgeons in uenced by the predominance of American urologists in this field have little or no place for the use of imaging modalities in determining whether a patient is suitable for radical prostatectomy with curative intent. They have endeavoured by combining clinical parameters to identify low, intermediate and high risk groups of patients for extra-capsular and possibly metastatic spread. There is acknowledgement that all of these scoring systems are limited and a concern that the optimal management of prostate cancer remains elusive, as 5-year biochemical failure rates for the surgical gold standard of radical prostatectomy range anywhere from 27% to 57%. Solace is taken in the fact (based on one study) that there appears to be an 8-year gap between evidence of biochemical progression and objective metastatic disease. Currently the relative localization of the disease is based on: