PROSTATE-CANCER CLINICAL GUIDELINES PANEL SUMMARY REPORT ON THE MANAGEMENT OF CLINICALLY LOCALIZED PROSTATE-CANCER

Purpose: The American Urological Association convened the Prostate Can cer Clinical Guidelines Panel to analyze the literature regarding avai lable methods for treating locally confined prostate cancer, and to ma ke practice policy recommendations based on the treatment outcomes dat a insofar as the data permit. Materials and Methods: The panel searche d the MEDLINE data base for all articles from 1966 to 1993 on stage T2 (B) prostate cancer and systematically analyzed outcomes data for rad ical prostatectomy, radiation therapy and surveillance as treatment al ternatives. Outcomes considered most important were survival at 5, 10 and 15 years, progression at 5, 10 and 15 years, and treatment complic ations. Results: The panel found the outcomes data inadequate for vali d comparisons of treatments. Differences were too great among treatmen t series with regard to such significant characteristics as age, tumor grade and pelvic lymph node status. The panel elected to display, in tabular form and graphically, the ranges in outcomes data reported for each treatment alternative. Conclusions: In making its recommendation s, the panel presented treatment alternatives as options, identifying the advantages and disadvantages of each, and recommended as a standar d that patients with newly diagnosed, clinically localized prostate ca ncer should be informed of all commonly accepted treatment options.