October 2010- Issues in prostate cancer such as active surveillance, positive surgical margins after robotic radical prostatectomy and the use of androgen ablation were discussed in the first plenary session of the 6th South Eastern European Meeting which opened today in Istanbul, Turkey.
"We have one of the highest attendance of the SEEM and this has inspired us to host future similar meetings,"said Prof. Ates Kadioglu, who together with Prof. Michael Marberger, chairman of the EAU Regional Office, welcomed the more than 450 participants attending the one-and-half day SEEM event.
In the opening plenary session prostate cancer issues topped the agenda wth active surveillance in prostate cancer patients examined by Prof. John Fitzpatrick (Dublin, Ireland). "Active surveillance is a feasible option," said Fitzpatrick. "One of the rationale of active surveillance is that it eliminates the danger of over-treating insignificant cancers generated by screening," Fitzpatrick added.
Prof. A. Hinev (Varna, Bulgaria) discussed surgical margin positivity following robotic radical prostatectomy (RRP) and examined various issues such as technical challenges in RRP, image modalities and the post-operative impact of radical prostatectomy. In his concluding remarks, Hinev highlighted the following:
- attention to technical details and increased surgical experience remain imperative in reducing the rate of positive surgical margins (PSM)
- pre-operative eMRI planning and intra-operative frozen section analysis may play a role in reducing the incidence of PSM, particularly in high risk patients.
- for men with PSM, radiotherapy is the only established treatment with curative potential. However, before definite recommendations can be made, randomised trials comparing adjuvant RT immediately after surgery to salvage RT at the earliest onset of PSA relapse are sorely needed.
Regarding androgen ablation treatment, Dr. D. Balbay (Ankara, Turkey) examined the range of androgen ablation treatment options including the timing of androgen deprivation therapy and intermittent androgen deprivation. Amongst his key messages are: minimal androgen blockage is most attractive when quality of life is the main concern, and that minimal androgen blockade should be considered as investigational until long term follow-up and larger controlled trials are available.