Stage T1A carcinoma of prostate

Haim Matzkin, Jay E. Patel, Jens Ealtwein, Mark S. Soloway

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

When presented with a post-TURP patient with pathologically confirmed Stage T1a disease, several points should be considered (Fig. 1). Is the patient's anticipated longevity and quality-of-life likely to be affected by the confirmed diagnosis? From current knowledge, men over the age of seventy or with co-morbid risk factors probably will not be adversely affected, and no treatment is required apart from expectant followup with semiannual DRE and serum PSA determinations. The group at risk seems to be the young patientwith a Stage T la tumor who is likely to survive more than ten years after the diagnosis. Data showing progression rates without treatment as high as 16-25 percent at eight to ten years seem to indicate the need for additional therapy. If the patient belongs to this category and is ready to pursue more aggressive treatment, reestablishing the diagnosis might be suggested, as well as an evaluation of the pre- and post-TUR PSA levels. This can be done by TRUS-guided biopsies of the prostate (or repeat TURP, which we regard as less preferable). If residual tumor is not found, we would counsel a "wait and see" approach. If subsequent tissue sampling identifies other than well-differentiated cancer or indicates the likelihood of more extensive cancer than the T la staging, treatment would be suggested. If the restaging reveals some residual well-differentiated disease that would not alter the initial staging of T la, the patient should be offered the alternatives of close monitoring, radical prostatectomy, or radiation therapy. Until prognostic factors such as DNA ploidyand nuclear roundness are better studied, we are unable to counsel the patient on the biologic significance/aggressiveness of his Stage T1a disease.

Original languageEnglish
Pages (from-to)11-21
Number of pages11
JournalUrology
Volume43
Issue number1
DOIs
StatePublished - Jan 1 1994
Externally publishedYes

Fingerprint

Prostate
Carcinoma
Transurethral Resection of Prostate
Therapeutics
Neoplasms
Residual Neoplasm
Prostatectomy
Radiotherapy
Quality of Life
Biopsy
DNA
Serum

ASJC Scopus subject areas

  • Urology

Cite this

Matzkin, H., Patel, J. E., Ealtwein, J., & Soloway, M. S. (1994). Stage T1A carcinoma of prostate. Urology, 43(1), 11-21. https://doi.org/10.1016/S0090-4295(94)80254-8

Stage T1A carcinoma of prostate. / Matzkin, Haim; Patel, Jay E.; Ealtwein, Jens; Soloway, Mark S.

In: Urology, Vol. 43, No. 1, 01.01.1994, p. 11-21.

Research output: Contribution to journalArticle

Matzkin, H, Patel, JE, Ealtwein, J & Soloway, MS 1994, 'Stage T1A carcinoma of prostate', Urology, vol. 43, no. 1, pp. 11-21. https://doi.org/10.1016/S0090-4295(94)80254-8
Matzkin H, Patel JE, Ealtwein J, Soloway MS. Stage T1A carcinoma of prostate. Urology. 1994 Jan 1;43(1):11-21. https://doi.org/10.1016/S0090-4295(94)80254-8
Matzkin, Haim ; Patel, Jay E. ; Ealtwein, Jens ; Soloway, Mark S. / Stage T1A carcinoma of prostate. In: Urology. 1994 ; Vol. 43, No. 1. pp. 11-21.
@article{565ba63f0ab6412c8a6996f246ff64d7,
title = "Stage T1A carcinoma of prostate",
abstract = "When presented with a post-TURP patient with pathologically confirmed Stage T1a disease, several points should be considered (Fig. 1). Is the patient's anticipated longevity and quality-of-life likely to be affected by the confirmed diagnosis? From current knowledge, men over the age of seventy or with co-morbid risk factors probably will not be adversely affected, and no treatment is required apart from expectant followup with semiannual DRE and serum PSA determinations. The group at risk seems to be the young patientwith a Stage T la tumor who is likely to survive more than ten years after the diagnosis. Data showing progression rates without treatment as high as 16-25 percent at eight to ten years seem to indicate the need for additional therapy. If the patient belongs to this category and is ready to pursue more aggressive treatment, reestablishing the diagnosis might be suggested, as well as an evaluation of the pre- and post-TUR PSA levels. This can be done by TRUS-guided biopsies of the prostate (or repeat TURP, which we regard as less preferable). If residual tumor is not found, we would counsel a {"}wait and see{"} approach. If subsequent tissue sampling identifies other than well-differentiated cancer or indicates the likelihood of more extensive cancer than the T la staging, treatment would be suggested. If the restaging reveals some residual well-differentiated disease that would not alter the initial staging of T la, the patient should be offered the alternatives of close monitoring, radical prostatectomy, or radiation therapy. Until prognostic factors such as DNA ploidyand nuclear roundness are better studied, we are unable to counsel the patient on the biologic significance/aggressiveness of his Stage T1a disease.",
author = "Haim Matzkin and Patel, {Jay E.} and Jens Ealtwein and Soloway, {Mark S.}",
year = "1994",
month = "1",
day = "1",
doi = "10.1016/S0090-4295(94)80254-8",
language = "English",
volume = "43",
pages = "11--21",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Stage T1A carcinoma of prostate

AU - Matzkin, Haim

AU - Patel, Jay E.

AU - Ealtwein, Jens

AU - Soloway, Mark S.

PY - 1994/1/1

Y1 - 1994/1/1

N2 - When presented with a post-TURP patient with pathologically confirmed Stage T1a disease, several points should be considered (Fig. 1). Is the patient's anticipated longevity and quality-of-life likely to be affected by the confirmed diagnosis? From current knowledge, men over the age of seventy or with co-morbid risk factors probably will not be adversely affected, and no treatment is required apart from expectant followup with semiannual DRE and serum PSA determinations. The group at risk seems to be the young patientwith a Stage T la tumor who is likely to survive more than ten years after the diagnosis. Data showing progression rates without treatment as high as 16-25 percent at eight to ten years seem to indicate the need for additional therapy. If the patient belongs to this category and is ready to pursue more aggressive treatment, reestablishing the diagnosis might be suggested, as well as an evaluation of the pre- and post-TUR PSA levels. This can be done by TRUS-guided biopsies of the prostate (or repeat TURP, which we regard as less preferable). If residual tumor is not found, we would counsel a "wait and see" approach. If subsequent tissue sampling identifies other than well-differentiated cancer or indicates the likelihood of more extensive cancer than the T la staging, treatment would be suggested. If the restaging reveals some residual well-differentiated disease that would not alter the initial staging of T la, the patient should be offered the alternatives of close monitoring, radical prostatectomy, or radiation therapy. Until prognostic factors such as DNA ploidyand nuclear roundness are better studied, we are unable to counsel the patient on the biologic significance/aggressiveness of his Stage T1a disease.

AB - When presented with a post-TURP patient with pathologically confirmed Stage T1a disease, several points should be considered (Fig. 1). Is the patient's anticipated longevity and quality-of-life likely to be affected by the confirmed diagnosis? From current knowledge, men over the age of seventy or with co-morbid risk factors probably will not be adversely affected, and no treatment is required apart from expectant followup with semiannual DRE and serum PSA determinations. The group at risk seems to be the young patientwith a Stage T la tumor who is likely to survive more than ten years after the diagnosis. Data showing progression rates without treatment as high as 16-25 percent at eight to ten years seem to indicate the need for additional therapy. If the patient belongs to this category and is ready to pursue more aggressive treatment, reestablishing the diagnosis might be suggested, as well as an evaluation of the pre- and post-TUR PSA levels. This can be done by TRUS-guided biopsies of the prostate (or repeat TURP, which we regard as less preferable). If residual tumor is not found, we would counsel a "wait and see" approach. If subsequent tissue sampling identifies other than well-differentiated cancer or indicates the likelihood of more extensive cancer than the T la staging, treatment would be suggested. If the restaging reveals some residual well-differentiated disease that would not alter the initial staging of T la, the patient should be offered the alternatives of close monitoring, radical prostatectomy, or radiation therapy. Until prognostic factors such as DNA ploidyand nuclear roundness are better studied, we are unable to counsel the patient on the biologic significance/aggressiveness of his Stage T1a disease.

UR - http://www.scopus.com/inward/record.url?scp=0028179896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028179896&partnerID=8YFLogxK

U2 - 10.1016/S0090-4295(94)80254-8

DO - 10.1016/S0090-4295(94)80254-8

M3 - Article

VL - 43

SP - 11

EP - 21

JO - Urology

JF - Urology

SN - 0090-4295

IS - 1

ER -