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Radical Prostatecto...
Radical Prostatectomy or Watchful Waiting in Prostate Cancer-29-Year Follow-up
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- Bill-Axelson, Anna (författare)
- Uppsala universitet,Urologkirurgi
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- Holmberg, Lars (författare)
- Uppsala universitet,Endokrinkirurgi,Kings Coll London, Sch Med, Div Canc Studies, London, England;Kings Coll London, Sch Canc & Pharmaceut Sci, London, England
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- Garmo, Hans (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kings Coll London, Sch Med, Div Canc Studies, London, England
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- Taari, K. (författare)
- Department of Urology, Helsinki University Hospital, Helsinki, Finland.,Helsinki Univ Hosp, Dept Urol, Helsinki, Finland
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- Busch, Christer (författare)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi,Urologkirurgi
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- Nordling, S. (författare)
- Department of Pathology, University of Helsinki, Helsinki, Finland,Univ Helsinki, Dept Pathol, Helsinki, Finland
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- Häggman, Michael (författare)
- Uppsala universitet,Urologkirurgi
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- Andersson, S. O. (författare)
- Department of Urology, Örebro University Hospital, Örebro, Sweden,Orebro Univ, Sch Hlth & Med Sci, Orebro, Sweden;Orebro Univ Hosp, Dept Urol, Orebro, Sweden
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- Andrén, Ove, 1963- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Urology,Orebro Univ, Sch Hlth & Med Sci, Orebro, Sweden;Orebro Univ Hosp, Dept Urol, Orebro, Sweden
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- Steineck, Gunnar, 1952 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology,Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, Gothenburg, Sweden,Sahlgrens Acad, Div Clin Canc Epidemiol, Gothenburg, Sweden
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- Adami, H. O. (författare)
- Karolinska Institutet
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- Johansson, J. E. (författare)
- Department of Urology, Örebro University Hospital, Örebro, Sweden,Orebro Univ, Sch Hlth & Med Sci, Orebro, Sweden;Orebro Univ Hosp, Dept Urol, Orebro, Sweden
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(creator_code:org_t)
- Massachussetts Medical Society, 2018
- 2018
- Engelska.
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Ingår i: New England Journal of Medicine. - : Massachussetts Medical Society. - 0028-4793 .- 1533-4406. ; 379:24, s. 2319-2329
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND Radical prostatectomy reduces mortality among men with clinically detected localized prostate cancer, but evidence from randomized trials with long-term followup is sparse. METHODS We randomly assigned 695 men with localized prostate cancer to watchful waiting or radical prostatectomy from October 1989 through February 1999 and collected follow-up data through 2017. Cumulative incidence and relative risks with 95% confidence intervals for death from any cause, death from prostate cancer, and metastasis were estimated in intention-to-treat and per-protocol analyses, and numbers of years of life gained were estimated. We evaluated the prognostic value of histopathological measures with a Cox proportional-hazards model. RESULTS By December 31, 2017, a total of 261 of the 347 men in the radical-prostatectomy group and 292 of the 348 men in the watchful-waiting group had died; 71 deaths in the radical-prostatectomy group and 110 in the watchful-waiting group were due to prostate cancer (relative risk, 0.55; 95% confidence interval [CI], 0.41 to 0.74; P<0.001; absolute difference in risk, 11.7 percentage points; 95% CI, 5.2 to 18.2). The number needed to treat to avert one death from any cause was 8.4. At 23 years, a mean of 2.9 extra years of life were gained with radical prostatectomy. Among the men who underwent radical prostatectomy, extracapsular extension was associated with a risk of death from prostate cancer that was 5 times as high as that among men without extracapsular extension, and a Gleason score higher than 7 was associated with a risk that was 10 times as high as that with a score of 6 or lower (scores range from 2 to 10, with higher scores indicating more aggressive cancer). CONCLUSIONS Men with clinically detected, localized prostate cancer and a long life expectancy benefited from radical prostatectomy, with a mean of 2.9 years of life gained. A high Gleason score and the presence of extracapsular extension in the radical prostatectomy specimens were highly predictive of death from prostate cancer.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Nyckelord
- cancer
- General & Internal Medicine
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Bill-Axelson, An ...
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Holmberg, Lars
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Garmo, Hans
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Taari, K.
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Busch, Christer
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Nordling, S.
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visa fler...
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Häggman, Michael
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Andersson, S. O.
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Andrén, Ove, 196 ...
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Steineck, Gunnar ...
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Adami, H. O.
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Johansson, J. E.
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- MEDICIN OCH HÄLSOVETENSKAP
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- Av lärosätet
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Göteborgs universitet
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Örebro universitet
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Uppsala universitet
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Karolinska Institutet