Begrippenlijst en algemene opmerkingen
Algemene opmerkingen
- Alle patiënten dienen bij ziekteprogressie multidisciplinair besproken te worden in de tumorwerkgroep gemetastaseerd prostaatkanker (TWG CRPC/prostaat). Bij mHSPC patiënten met een stijgend PSA na lokale therapie dient na PSMA-PET imaging beleid te worden gemaakt in de TWG (salvage behandeling, androgeen deprivatie of expectatief).
- Indien bij patiënt moleculaire tumordiagnostiek wordt verricht dan kan de uitslag van deze diagnostiek gebruikt worden om te bepalen of er reden is voor kiembaandiagnostiek conform de leidraad op de website arts en genetica (Leidraad voor verwijzing na DNA-onderzoek in (tumor)weefsel | Arts en Genetica). Zonder moleculaire tumordiagnostiek bespreek verwijzing naar klinisch geneticus bij een hoge gleasonscore (zeven of hoger) in combinatie met een belaste familieanamnese (zie Richtlijnen boekje Stichting opsporing erfelijke tumoren (stoet.nl)) en zo niet overweeg deelname aan DISCOVER studie zolang deze studie loopt.
- Moleculaire tumordiagnostiek uitvoeren bij patiënten met gemetastaseerd prostaatkanker. Dit kan zijn bij diagnose mHSPC of bij bereiken castratie-resistentie. Gezien de vele wetenschappelijke ontwikkelingen zal een behandeling steeds meer gepersonaliseerd worden. Moleculaire diagnostiek zal hierin (steeds vroeger in de behandeling) een prominente rol krijgen.
Begrippenlijst
- Gemetastaseerd Hormoon sensitieve (naïef) prostaatcarcinoom (mHSPC/mHNPC)
- Gemetastaseerd Castratieresistent prostaatcarcinoom (mCRPC)
- Synchroon gemetastaseerd prostaatcarcinoom= Bij diagnose van primaire tumor al gemetastaseerde ziekte.
- Metachroon gemetastaseerd prostaatcarcinoom = Na primaire behandeling gemetastaseerd ziekte.
- Laag-volume ziekte= Wanneer niet aan hoog-volume wordt voldaan.
- Hoog-volume ziekte= Viscerale metastasen of ≥ 4 botmetastasen waarvan 1 of meer buiten de wervelkolom en het bekken
Tumorsoorten
Literatuur
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