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Gleason score 7 scr...
Gleason score 7 screen-detected prostate cancers initially managed expectantly: outcomes in 50 men.
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van den Bergh, Roderick C N (författare)
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Roemeling, Stijn (författare)
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Roobol, Monique J (författare)
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- Aus, Gunnar, 1958 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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- Hugosson, Jonas, 1955 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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Rannikko, Antti S (författare)
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Tammela, Teuvo L (författare)
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Bangma, Chris H (författare)
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Schröder, Fritz H (författare)
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(creator_code:org_t)
- 2009
- 2009
- Engelska.
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Ingår i: BJU international. - 1464-410X. ; 103:11, s. 1472-7
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Aged
- Epidemiologic Methods
- Humans
- Male
- Middle Aged
- Prognosis
- Prostate-Specific Antigen
- blood
- Prostatic Neoplasms
- blood
- mortality
- pathology
- therapy
- Survival Analysis
- Treatment Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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van den Bergh, R ...
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Roemeling, Stijn
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Roobol, Monique ...
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Aus, Gunnar, 195 ...
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Hugosson, Jonas, ...
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Rannikko, Antti ...
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visa fler...
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Tammela, Teuvo L
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Bangma, Chris H
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Schröder, Fritz ...
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visa färre...
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