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Triple treatment of...
Triple treatment of high-risk prostate cancer. A matched cohort study with up to 19 years follow-up comparing survival outcomes after triple treatment and treatment with hormones and radiotherapy
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Gunnarsson, O. (författare)
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- Schelin, S. (författare)
- Karolinska Institutet
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Brudin, L. (författare)
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Carlsson, S. (författare)
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- Damber, Jan-Erik, 1949 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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(creator_code:org_t)
- 2019-04-16
- 2019
- Engelska.
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 53:2-3, s. 102-108
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Purpose: To evaluate the efficacy of a triple treatment strategy, including surgery, on high risk prostate cancer comparing long-term survival outcome with a cohort receiving standard radiotherapy with endocrine therapy. Materials and methods: This study compared two cohorts in survival outcomes, matched on the year of diagnosis and age. In both groups there was a curative intention to treat localized high-risk prostate cancer (one or more of Gleason score 8-10, PSA 20-50 or stage T3), diagnosed between 1995-2010, follow-up at the end of 2014. Triple treatment group: 153 patients treated primarily with radical prostatectomy with neoadjuvant endocrine treatment, and a majority with adjuvant radiotherapy. Standard radiotherapy group: 702 patients with a treatment of either external radiotherapy or high dose brachytherapy combined with external beam therapy, both modalities in combination with neoadjuvant endocrine therapy. Results: The prostate-cancer-specific mortality was 10% for the triple treatment group and 15% for the standard radiotherapy group during the period, HR = 2.01 (1.17-3.43), p = 0.011. The corresponding overall mortality was 26% vs 29%, HR = 1.54 (1.09-2.17), p = 0.015. High Gleason score was the dominating risk factor for early death due to the disease. Clinical T-stage was not an independent risk factor for death in this population. Conclusion: Adding surgery in a multimodal treatment model in high-risk prostate cancer showed significantly better survival outcome compared with the current standard of radiotherapy. Surgery in this group is, therefore, compelling and that also includes a clinical T3-stage of the disease. The study is limited by possible selection bias for the two treatment models.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Prostate cancer
- radical prostatectomy
- radiotherapy
- multimodal treatment
- high-risk prostate
- long-term survival
- radical prostatectomy
- endocrine treatment
- radiation-therapy
- mortality
- classification
- comorbidities
- impact
- age
- Urology & Nephrology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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