Prostate Cancer Scientific Abstracts - P. Dahm

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Selected P. Dahm prostate cancer abstracts

Journal: Current Opinion in Urology

Pubmed ID: 16679853

Authors: Dahm P.

Title: Evidence-based medicine in prostate cancer: where do we stand in 2006?
PURPOSE OF REVIEW: A majority of medical decisions relating to the diagnosis, prognosis, and therapy of prostate cancer are based on low levels of evidence. This article reviews the recommendations of currently available evidence-based practice guidelines that relate to the management of patients with newly diagnosed prostate cancer. The article further introduces a selection of recent studies that are relevant to the evidence-based patient care.

RECENT FINDINGS: Updated clinical practice guidelines on the management of prostate-cancer patients provide an evidence-based summary of the literature and have recently been made available through the National Cancer Center Network and the European Urological Association. In addition, several recent high-quality studies have made major contributions to our knowledge of the natural history and therapy of prostate cancer.

SUMMARY: The efforts of professional associations to generate evidence-based guidelines are reflective of an increased awareness that the care of prostate cancer should--to the greatest possible extent--be evidence-based. Practicing urologists should seek to become involved in the evidence-based medicine process by supporting the accrual to high-quality clinical trials, demanding the highest standards to the timely and unbiased dissemination of research findings and ultimately, strive to apply the best available evidence to the care of individual patients.
Contact: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.

dahm0001@mc.duke.edu

Journal: The Journal of Urology

Pubmed ID: 15947597

Authors: Dahm P, Yang BK, Salmen CR, Moul JW, Gan TJ.

Title: Radical perineal prostatectomy for the treatment of localized prostate cancer in morbidly obese patients.
PURPOSE: We assessed the feasibility of radical perineal prostatectomy (RPP) in morbidly obese patients with clinically organ confined prostate cancer.

MATERIALS AND METHODS: Of 1,265 consecutive patients who underwent RPP at our institution from 1992 to 2003 we identified 18 with a body mass index (BMI) of 40 kg/m or greater. Demographic and clinical patient characteristics were obtained from the medical records, which were further reviewed to identify the perioperative incidence of surgical and anesthesia related complications.

RESULTS: Median BMI was 41.7 kg/m (range 40.2 to 62.6). Five patients had a BMI of 45.0 kg/m or greater. No intraoperative or anesthesia related complication occurred. Mean operative time +/- SD was 188 +/- 32 minutes and estimated blood loss was 573 +/- 285 ml. None of the 18 patients received blood transfusions. During the immediate postoperative period 4 complications occurred in the form of lower extremity neuropraxia in 2 patients, local skin bleeding in 1 and early sepsis in 1 requiring rehospitalization for intravenous antibiotics. Mean operative time and estimated blood loss were significantly lower when surgery was performed by a highly experienced surgeon compared with experienced surgeons (174 +/- 21 vs 235 +/- 10 minutes and 485 +/- 258 vs 838 +/- 197 ml, p = 0.001 and 0.027, respectively).

CONCLUSIONS: RPP in morbidly obese patients is feasible and it is associated with acceptable perioperative morbidity. The perineal approach should be considered in morbidly obese patients seeking surgical treatment for clinically localized prostate cancer.