{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:35:03Z","timestamp":1761762903758},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"865","license":[{"start":{"date-parts":[[1997,11,1]],"date-time":"1997-11-01T00:00:00Z","timestamp":878342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,11,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>The incidence and prevalence of prostate cancer is increasing. A number of aetiological factors including age, race, family history and diet have been implicated. The majority of patients present with disease which is amenable only to palliation. Digital rectal examination, serum prostate-specific antigen and transrectal ultrasound can lead to a prostatic biopsy. Transrectal ultrasound, magnetic resonance imaging, bone scan and a chest X-ray are used for staging. The management of localised cancer is shrouded in uncertainty. Three options exist, watchful waiting, radiotherapy, and radical total prostatectomy. The published data are inadequate for a valid comparison of these, and none has been shown to offer an advantage. Surgery, and to a lesser degree radiotherapy, have a significant morbidity. It is hoped that through better understanding our management of this disease will improve.<\/jats:p>","DOI":"10.1136\/pgmj.73.865.691","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:49:00Z","timestamp":1230587340000},"page":"691-696","source":"Crossref","is-referenced-by-count":4,"title":["Localised carcinoma of the prostate: a paradigm of uncertainty"],"prefix":"10.1093","volume":"73","author":[{"given":"S S","family":"Sandhu","sequence":"first","affiliation":[{"name":"Department of Urology, Royal Free Hospital School of Medicine , London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A V","family":"Kaisary","sequence":"additional","affiliation":[{"name":"Department of Urology, Royal Free Hospital School of Medicine , London NW3 2QG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1997,11,1]]},"reference":[{"key":"ref_1","article-title":"The Stanford series consists of 1119 patients (from October 1956 to December 1990) treated with external beam irradiation derived from a midto high-energy linear accelerator (range, 6-25 mV); 673 patients had disease limited to the prostate.34 These authors found survival to be inversely proportional to clinical stage and pathological grade. At 15 years the survival rates for the best prognosis tumours were equivalent to that of an age-matched cohort, ie, 50% at 15 years, however, the poorer prognosis tumours had a survival rate of 18% at 15 years. Age had no influence on outcome","unstructured":"The Stanford series consists of 1119 patients (from October 1956 to December 1990) treated with external beam irradiation derived from a midto high-energy linear accelerator (range, 6-25 mV); 673 patients had disease limited to the prostate.34 These authors found survival to be inversely proportional to clinical stage and pathological grade. At 15 years the survival rates for the best prognosis tumours were equivalent to that of an age-matched cohort, ie, 50% at 15 years, however, the poorer prognosis tumours had a survival rate of 18% at 15 years. Age had no influence on outcome."},{"key":"ref_2","article-title":"The absence of hard data is a constant source of embarrassment to all health professionals involved in the management of localised carcinoma of the prostate. The Department of Veterans Affairs and the National Cancer Institute's Cancer Therapy Evaluation Programme Cooperative Study (The Prostate Cancer Intervention Versus Observation Trial (PIVOT)), is a randomised trial designed to determine the benefits of early intervention with radical prostatectomy compared to surveillance. PIVOT will enrol 2000 patients over a three-year period and follow-up will be for a minimum of 12 years. Radiotherapy has not been included as a third treatment arm because of sample size, cost, and feasibility. This study should hopefully answer some of the questions","unstructured":"The absence of hard data is a constant source of embarrassment to all health professionals involved in the management of localised carcinoma of the prostate. The Department of Veterans Affairs and the National Cancer Institute's Cancer Therapy Evaluation Programme Cooperative Study (The Prostate Cancer Intervention Versus Observation Trial (PIVOT)), is a randomised trial designed to determine the benefits of early intervention with radical prostatectomy compared to surveillance. PIVOT will enrol 2000 patients over a three-year period and follow-up will be for a minimum of 12 years. Radiotherapy has not been included as a third treatment arm because of sample size, cost, and feasibility. This study should hopefully answer some of the questions."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/0046-8177(92)90102-9","article-title":"Early detection of prostate cancer","volume":"23","author":"Scardino, P.T.; Weaver, R.; Hudson, M.A.","year":"1992","unstructured":"Scardino PT, Weaver R, Hudson MA. Early detection of prostate cancer. 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Influence of patient age on the serum PSA concentration. An important clinical observation. Urol Clin NAm 1993; 20: 607 - 20.","journal-title":"Urol Clin NAm"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/S0022-5347(17)37393-7","article-title":"Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer","volume":"147","author":"Benson, M.C.; Whang, I.S.; Pantuck, A.","year":"1992","unstructured":"Benson MC, Whang IS, Pantuck A, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. 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Is the technology leading the science","volume":"168","author":"McClennan, B.L.","year":"1988","unstructured":"McClennan BL. Transrectal ultrasound of the prostate. Is the technology leading the science. Radiology 1988; 168: 571-5.","journal-title":"Radiology"},{"issue":"95 -100","key":"ref_23","article-title":"The echogenic focus in prostatic sonograms with xeroradiographic and histopathologic correlation","volume":"159","author":"Danhert, W.F.; Hamper, U.M.; Walsh, P.C.","year":"1986","unstructured":"Danhert WF, Hamper UM, Walsh PC, et al. The echogenic focus in prostatic sonograms with xeroradiographic and histopathologic correlation. 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UrolClinNorthAm 1989; 16: 71324.","journal-title":"UrolClinNorthAm"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/j.1464-410X.1974.tb03854.x","article-title":"Technetium-99m polyphosphate bone scanning in carcinoma of the prostate","volume":"128","author":"Lentle, B.C.; Mcgown, D.G.; Dierich, H.","year":"1974","unstructured":"Lentle BC, Mcgown DG, Dierich H. Technetium-99m polyphosphate bone scanning in carcinoma of the prostate. Br J Urol 1974; 128: 543-8.","journal-title":"Br J Urol"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/S0022-5347(17)56761-0","article-title":"The impact of current staging procedures in assessing the disease extent of prostatic adenocarcinoma","volume":"121","author":"Paulson, D.F.","year":"1979","unstructured":"Paulson DF. The impact of current staging procedures in assessing the disease extent of prostatic adenocarcinoma. J Urol 1979; 121: 300-2.","journal-title":"J Urol"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0090-4295(99)80161-7","article-title":"Serum prostate specific antigen and the biologic progression of prostate cancer","volume":"46","author":"Kabalin, J.N.; McNeal, J.E.; Johnstone, I.M.; Stamey, T.A.","year":"1995","unstructured":"Kabalin JN, McNeal JE, Johnstone IM, Stamey TA. Serum prostate specific antigen and the biologic progression of prostate cancer. Urology 1995; 46: 65-70.","journal-title":"Urology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S0090-4295(94)80050-2","article-title":"Utility of preoperative serum PSA concentration and biopsy Gleason score in predicting risk of pelvic lymph node metastases in prostate cancer","volume":"44","author":"Naryan, P.; Fournier, G.; Gajendran, V.","year":"1994","unstructured":"Naryan P, Fournier G, Gajendran V, et al. 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Cancer 1991; 67: 1091-6.","journal-title":"Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/j.1464-410X.1992.tb15493.x","article-title":"Deferred treatment in clinically localised prostatic cancer","volume":"169","author":"Adolfsson, J.; Carstensen, J.; Lowhagen, T.","year":"1992","unstructured":"Adolfsson J, Carstensen J, Lowhagen T. Deferred treatment in clinically localised prostatic cancer. BrJ Urol 1992; 169: 183-7.","journal-title":"BrJ Urol"},{"issue":"1","key":"ref_35","first-page":"204","article-title":"for the MRC Prostate Cancer Working Party and Investigators. Hormone therapy in advanced prostate cancer - report of the Medical Research Council 'immediate' versus 'deferred' treatment study","volume":"77","author":"Kirk, D.","year":"1996","unstructured":"Kirk D, for the MRC Prostate Cancer Working Party and Investigators. 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