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Time without PSA re...
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Ahlberg, Mats SteinholtzUppsala universitet,Urologkirurgi
(författare)
Time without PSA recurrence after radical prostatectomy as a predictor of future biochemical recurrence, metastatic disease and prostate cancer death : a prospective Scandinavian cohort study
- Artikel/kapitelEngelska2022
Förlag, utgivningsår, omfång ...
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2022-12-29
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BMJ Publishing Group Ltd,2022
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-497720
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-497720URI
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https://doi.org/10.1136/bmjopen-2021-057242DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:151852782URI
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https://gup.ub.gu.se/publication/323633URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Objective: Although surveillance after radical prostatectomy routinely includes repeated prostate specific antigen (PSA)-testing for many years, biochemical recurrence often occurs without further clinical progression. We therefore hypothesised that follow-up can be shortened for many patients without increasing the risk of prostate cancer death. We investigated the long-term probabilities of PSA recurrence, metastases and prostate cancer death in patients without biochemical recurrence five and 10 years after radical prostatectomy.Design: Prospective cohort study. Stratification by Gleason score (<= 3+4=7or >= 4+3=7), pathological tumour stage (pT2 or >= pT3) and negative or positive surgical margins.Setting: Between 1989 and 1998, 14 urological centres in Scandinavia randomised patients to the Scandinavian Prostate Cancer Group study number 4 (SPCG-4) trial.ParticipationAll 306 patients from the SPCG-4 trial who underwent radical prostatectomy within 1year from inclusion were eligible. Four patients were excluded due to surgery-related death (n=1) or salvage radiotherapy or hormonal treatment within 6weeks from surgery (n=3).Primary outcome measures: Cumulative incidences and absolute differences in metastatic disease and prostate cancer death.Results: We analysed 302 patients with complete follow-up during a median of 24 years. Median preoperative PSA was 9.8ng/mL and median age was 65 years. For patients without biochemical recurrence 5 years after radical prostatectomy the 20-year probability of biochemical recurrence was 25% among men with Gleason score <= 3+4=7and 57% among men with Gleason score >= 4+3=7; the probabilities for metastases were 0.8% and 17%; and for prostate cancer death 0.8% and 12%, respectively. The long-term probabilities were higher for pT >= 3versus pT2 and for positive versus negative surgical margins. Limitations include small size of the cohort.Conclusion: Many patients with favourable histopathology without biochemical recurrence 5years after radical prostatectomy could stop follow-up earlier than 10 years after radical prostatectomy.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Garmo, HansUppsala universitet,Urologkirurgi(Swepub:uu)hga27600
(författare)
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Adami, Hans-OlovKarolinska Institutet,Univ Oslo, Inst Hlth & Soc, Clin Effectiveness Grp, Oslo, Norway.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
(författare)
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Andren, OveÖrebro Univ, Fac Med & Hlth, Dept Urol, Örebro, Sweden.
(författare)
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Johansson, Jan-ErikÖrebro Univ, Fac Med & Hlth, Dept Urol, Örebro, Sweden.
(författare)
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Steineck, Gunnar,1952Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för onkologi,Institute of Clinical Sciences, Department of Oncology(Swepub:gu)xstegu
(författare)
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Holmberg, LarsKings Coll London, Sch Canc & Pharmaceut Sci, London, England.
(författare)
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Bill-Axelson, AnnaUppsala universitet,Urologkirurgi(Swepub:uu)anbil030
(författare)
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Uppsala universitetUrologkirurgi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:BMJ Open: BMJ Publishing Group Ltd12:122044-6055
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