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15 Cards in this Set
- Front
- Back
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What was PLCO trial?
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(-) study for screening; NEJM 3.18.09: usual care vs annual PSA for 6yrs/DRE 4 yrs; Conclusion: after 7-10yrs, rate of PrCa was low and didn't differ by grp; contamination by 52% men in control grp had PSA
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What was ERSPC study?
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(+) study for screening: 7 different European countries: PSA q4yrs vs no PSA; Cancer-specific survival reduced by 20% in screening grp...Goteborg Arm 2010: PSA q2yrs vs none: 40% risk reduction; 234 men would need to be screened and 15 cancers dx to prevent one death from PrCa
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What does the AUA guidelines say about screening?
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baseline PSA at 40; no longer recommends single, threshold PSA
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What was SELECT trial?
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negative trial of vit E and selenium to prevent PrCa
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What was REDUCE trial?
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(+) trial showing 23% reduction in PrCa with no risk of inc grade cancer with dutasteride
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What is the low risk stratification for localized disease?
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G less than 7, less than 34% cores with Ca, PSA less than 10, PSAV less than 2, PSAD less than 0.15, DRE negative
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What is the intermediate risk stratification for localized disease?
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G = 7, 34-50% cores with Ca, PSA 10-20, PSAV less than 2, PSAD less than 0.15, DRE small nodule
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What is the high risk stratification for localized disease?
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G more than 7, more than 50% cores with Ca, PSA more than 20, PSAV more than 2, DRE large nodule
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What are the score ranges for the AUA symptom score?
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1-7 (mild); 8-19 (mod); 20-35 (severe); QOL: 0-6 (6 is worst)
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What is the AUA definition of PSA recurrence post-RRP?
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greater than 0.2ng/mL with repeat confirmation
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what do you do with small cell carcinoma of the prostate?
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cisplatin-based chemotx; radiation is ineffective, as is surgery alone
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what's the best predictor of long-term disease-free survival after salvage RRP?
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PSA less than 10 ng/mL
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what's an excellent predictor of outcome after definitive XRT?
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PSA nadir less than 0.5 ng/mL
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what is the quickest method of pharmacologically establishing a castrate state for symptomatic bone mets?
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ketoconazole (within 48hrs); GnRH pure antagonist degarelix (96% castrate at day 3)
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what hormonal therapy for PrCa is most likely to cause visual disturbances?
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nilutamide: light to dark adaption (also rare pulmonary fibrosis)
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