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Immediate versus de...
Immediate versus delayed prostatectomy : Nationwide population-based study
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- Loeb, Stacy (författare)
- NYU, New York, NY USA.;Manhattan Vet Affairs Med Ctr, New York, NY USA.,Veterans Health Administration Office of Research and Development
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- Folkvaljon, Yasin (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
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- Robinson, David (författare)
- Umea Univ Hosp, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden.;Ryhov Cty Hosp, Dept Urol, Jonkoping, Sweden.,Ryhov County Hospital, Jönköping
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- Makarov, Danil V. (författare)
- NYU, New York, NY USA.;Manhattan Vet Affairs Med Ctr, New York, NY USA.,Veterans Health Administration Office of Research and Development
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- Bratt, Ola (författare)
- Lund University,Lunds universitet,Bröstcancer-genetik,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Breastcancer-genetics,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Addenbrooke's Hospital,Addenbrookes Hosp, CamPARI Clin, Dept Urol, Cambridge, England.;Lund Univ, Dept Translat Sci, Lund, Sweden.
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- Garmo, Hans (författare)
- Kings Coll London, Div Canc Studies, Fac Life Sci & Med, London, England.,King's College London
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- Stattin, Pär (författare)
- Uppsala University,Uppsala universitet,Urologkirurgi,Umea Univ Hosp, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden.
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NYU, New York, NY USA;Manhattan Vet Affairs Med Ctr, New York, NY USA. Veterans Health Administration Office of Research and Development (creator_code:org_t)
- 2016-04-12
- 2016
- Engelska.
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Ingår i: Scandinavian journal of urology. - : Informa UK Limited. - 2168-1805 .- 2168-1813. ; 50:4, s. 246-254
- Relaterad länk:
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https://europepmc.or...
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.3...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- Objective: The aim of this study was to compare the outcome of immediate versus delayed radical prostatectomy (RP) in men with low-grade prostate cancer. Materials and methods: The study included a nationwide population-based cohort in the National Prostate Cancer Register of Sweden, of 7608 men with clinically localized, biopsy Gleason score 6 prostate cancer who underwent immediate or delayed RP in 1997-2007. Multivariable models compared RP pathology, use of salvage radiotherapy and prostate cancer mortality based on timing of RP (< 1, 1-2 or > 2 years after diagnosis). Median follow-up was 8.1 years. Results: Men undergoing RP more than 2 years after diagnosis had a higher risk of Gleason upgrading [odds ratio 2.93, 95% confidence interval (CI) 2.34-3.68] and an increased risk of salvage radiotherapy [hazard ratio (HR) 1.90, 95% CI 1.41-2.55], but no significant increase in prostate cancer-specific mortality (HR 1.85, 95% CI 0.57-5.99). In competing risk analysis, 7 year prostate cancer-specific cumulative mortality was similar, at less than 1%, for immediate RP and active surveillance regardless of later intervention. Limitations of this study include the lack of data on follow-up biopsies and the limited follow-up time. Conclusion: Men undergoing RP more than 2 years after diagnosis had more adverse pathological features and second line therapy, highlighting the trade-off in deferring immediate curative therapy. However, men with delayed RP constitute a minority with higher risk cancer among the much larger group of low-risk men initially surveilled, and the overall risk of prostate cancer mortality at 7 years was similarly low with immediate RP or active surveillance.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Active surveillance
- outcomes
- prognosis
- prostate cancer
- radical prostatectomy
- surgical delay
- Active surveillance
- outcomes
- prognosis
- prostate cancer
- radical prostatectomy
- surgical delay
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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