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Counterpoint: Prostate carcinoma treatment for the young patient—The case for radical prostatectomy

  • Alex Shteynshlyuger
    Affiliations
    Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
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  • Adam S. Kibel
    Correspondence
    Corresponding author. Division of Urologic Surgery, 2nd Floor, Wohl Hospital, Washington University School of Medicine, 4960 Children's Place, Box 8242, St. Louis, MO 63105. Tel.: +1-314-362-8295.
    Affiliations
    Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO

    Alvin J. Siteman Cancer Center, Washington University, St. Louis, MO
    Search for articles by this author
      The National Cancer Institute estimates 192,280 new cases of prostate cancer and 27,360 deaths from prostate cancer in 2009 (
      • Jemal A.
      • Siegel R.
      • Ward E.
      • et al.
      Cancer statistics, 2009.
      ) making prostate carcinoma the most common malignancy and second most common cause of cancer death in men. Introduction of prostate specific antigen (PSA)-based screening in the early 1990s, along with increased use of aggressive therapy (
      • Thompson I.M.
      • Tangen C.M.
      • Paradelo J.
      • et al.
      Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: Long-term followup of a randomized clinical trial.
      ,
      • Bill-Axelson A.
      • Holmberg L.
      • Filen F.
      • et al.
      Radical prostatectomy versus watchful waiting in localized prostate cancer: The Scandinavian prostate cancer group-4 randomized trial.
      ,
      • Tannock I.F.
      • de Wit R.
      • Berry W.R.
      • et al.
      Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer.
      ), has led to a dramatic increase in the number of cases diagnosed, improved disease-free survival, and a 4.1% drop in mortality per year since 1994 (
      • Jemal A.
      • Siegel R.
      • Ward E.
      • et al.
      Cancer statistics, 2009.
      ).
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