Advances in high-risk localized prostate cancer: Staging and management.

Nearly 15% of individuals with localized prostate cancer are identified as high risk for recurrence and progression of the disease, which is why the correct staging is vital for the definition of correct treatment-also developing novel therapeutic strategies to find a balance between getting better outcomes without sacrificing the quality of life (QoL). In this narrative review, we introduced the current standards of staging and primary treatment of high-risk localized prostate cancer (PCa), based on international guidelines and arguments in the debate, under the light of the most recent literature. It brings essential tools such as PSMA PET/CT and different nomograms (Briganti. MSKCC, Gandaglia) for accurate staging and selecting wisely the definitive therapy. Even though there is a broad discussion over the best local treatment in curative-intent treatment, it looks more important to define which patient profile would adapt correctly to every different treatment, highlighting the benefits and superior outcomes with multimodal treatment.

Overall survival and prognostic factors in Stage I lung adenocarcinoma treated with curative intent: A real-life 19-year cohort study.

OBJECTIVES: Important differences in Stage I non-small-cell lung cancer (NSCLC) are related to the delay in the diagnosis to the treatment, hospitals' specialised status, comorbidities, tumour stage and histological type. METHODS: A 19-year retrospective cohort study was conducted, including 681 patients with NSCLC in clinical-stage IA-IB. The variables analysed were gender, age, schooling, type of health care provider, type of treatment, period of 5-year treatment, the time between first attendance to diagnosis and the time between diagnosis and treatment, and hospital's specialised status. RESULTS: Patients who underwent radiotherapy alone had three times more risk of death than those who underwent surgery alone (adjusted hazard ratio [adjHR] = 3.44; 95% confidence interval [CI]: 2.45-4.82; p <0.001). The independent risk of death factors was being treated in nonhigh complexity centres in oncology hospitals and having started the treatment more than 2 months after diagnosis (adjHR = 1.80; 95% CI: 1.26-2.56; p <0.001) and (adjHR = 2.00; 95% CI: 1.33-3.00; p <0.001), respectively. In addition, the patients diagnosed between 2011 and 2015 had a 40% lower risk of death when compared to those diagnosed between 2000 and 2005 (95% CI: 0.38-0.94; p = 0.027). CONCLUSION: The overall survival in curative intent Stage-I lung cancer patients' treatment was associated with the 5-year diagnosis group, the delayed time between diagnosis and treatment and the hospital qualification.