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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004037naa a2200541 4500
001oai:gup.ub.gu.se/104471
003SwePub
008240528s2009 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/1044712 URI
0247 a https://doi.org/10.1111/j.1464-410X.2008.08281.x2 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a van den Bergh, Roderick C N4 aut
2451 0a Gleason score 7 screen-detected prostate cancers initially managed expectantly: outcomes in 50 men.
264 1c 2009
520 a OBJECTIVE To assess whether men newly diagnosed with Gleason 7 prostate cancer are eligible for active surveillance (AS) instead of radical treatment. AS is an appropriate initial strategy in selected men who are presently diagnosed with prostate cancer, as many tumours will not progress during a patient's lifetime. PATIENTS AND METHODS Cancer-specific-, overall and treatment-free survival were analysed retrospectively in men with Gleason score 7 cancer who were initially managed expectantly. All were screen-detected in four centres of the European Randomized Study of Screening for Prostate Cancer. RESULTS In 50 men active therapy was initially withheld if they had Gleason 7 disease; 29 of 50 (58%) would otherwise have been suitable for AS, as they had a prostate-specific antigen (PSA) level of < or =10.0 ng/mL, a PSA density of <0.2 ng/mL/mL, stage T1c/T2, and two or fewer positive biopsy-cores; 44 of 50 (88%) had a Gleason score 3 + 4 = 7. The mean (range) age of the men was 69.5 (59.6-76.2) years and the median (interquartile range) follow-up was 2.6 (0.8-5.0) years; the mean American Society of Anesthesiologists score was 1.8. The 6-year cancer-specific survival (nine patients at risk) was 100%, which sharply contrasted with the 68% overall survival. Men alive at the time of analysis had a favourable PSA level and PSA-doubling time. The 6-year treatment-free survival was only 59%, with most patients switching to active therapy, justified on the basis of their PSA level. However, men with otherwise favourable tumour characteristics and a Gleason score of 3 + 4 = 7 remained treatment-free significantly longer than their counterparts with unfavourable other tumour features and a Gleason score of 4 + 3 = 7. CONCLUSION In selected patients with screen-detected Gleason 3 + 4 = 7 prostate cancer, AS might be an option, especially in those with comorbidity and/or a short life-expectancy.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Urologi och njurmedicin0 (SwePub)302142 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Urology and Nephrology0 (SwePub)302142 hsv//eng
653 a Aged
653 a Epidemiologic Methods
653 a Humans
653 a Male
653 a Middle Aged
653 a Prognosis
653 a Prostate-Specific Antigen
653 a blood
653 a Prostatic Neoplasms
653 a blood
653 a mortality
653 a pathology
653 a therapy
653 a Survival Analysis
653 a Treatment Outcome
7001 a Roemeling, Stijn4 aut
7001 a Roobol, Monique J4 aut
7001 a Aus, Gunnar,d 1958u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences4 aut
7001 a Hugosson, Jonas,d 1955u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences4 aut0 (Swepub:gu)xhugjo
7001 a Rannikko, Antti S4 aut
7001 a Tammela, Teuvo L4 aut
7001 a Bangma, Chris H4 aut
7001 a Schröder, Fritz H4 aut
7102 a Göteborgs universitetb Institutionen för kliniska vetenskaper4 org
7730 t BJU internationalg 103:11, s. 1472-7q 103:11<1472-7x 1464-410X
8564 8u https://gup.ub.gu.se/publication/104471
8564 8u https://doi.org/10.1111/j.1464-410X.2008.08281.x

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