[Do results of surgical treatment of cancer clinically localized to the
prostate justify early screening?]

Rohner S; Graber P

Schweiz Rundsch Med Prax 1997;86(44):1730-3
Departement de Chirurgie, Hopital Cantonal Universitaire, Geneve.

Prostate cancer is the most common malignancy and represents the
second leading cause of cancer death in men of western countries.
Mortality of this tumor is particularly high beyond ten years. For
patients with more than 10 years of life expectancy, curative
treatment, if available, is mandatory. For the others, observation
and differed hormonal palliative treatment is a reasonable alternati-
ve. Radical prostatectomy is the gold standard for treatment of
clinically localized prostatic cancer. Cure rate is very high when
the tumor histologically is strictly confined to the prostate.
Morbidity has been reduced with the development of the anatomical
approach. Our experience suggests that this reduced morbidity can
also be achieved in urology clinics with relatively low recruitment.
In addition, our results show that chances for cure are still very
high for tumors reaching or even penetrating the prostatic capsule,
as long as the seminal vesicles are not invaded. Early screening of
the Prostate diagnoses a vast majority of tumors before the stage of
seminal vesicle invasion. Early screening may thus be recommended for
patients with 10 years or more of life expectancy.