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Radical prostatecto...
Radical prostatectomy versus watchful waiting in localized prostate cancer : the Scandinavian prostate cancer group-4 randomized trial
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- Bill-Axelson, Anna (författare)
- Uppsala universitet,Urologkirurgi,Department of Urology, University Hospital, Uppsala, Sweden
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- Holmberg, Lars (författare)
- Uppsala universitet,Endokrinkirurgi,Regional Oncologic Center, University Hospital, Uppsala, Sweden, King's College London, School of Medicine, Division of Cancer Studies, London, United Kingdom, Medical School, Division of Cancer Studies, Guy's Hospital, London SE1 9RT, United Kingdom
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- Filén, Frej (författare)
- Uppsala universitet,Urologkirurgi,Filén, F., Department of Urology, University Hospital, Uppsala, Sweden
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- Ruutu, Mirja (författare)
- Department of Urology, Helsinki University Central Hospital, Helsinki, Finland
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- Garmo, Hans (författare)
- Regional Oncologic Center, University Hospital, Uppsala, Sweden
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- Busch, Christer (författare)
- Uppsala universitet,Institutionen för genetik och patologi,Department of Pathology, University Hospital, Uppsala, Sweden
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- Nordling, Stig (författare)
- Department of Pathology, Helsinki University Central Hospital, Helsinki, Finland
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- Häggman, Michael (författare)
- Uppsala universitet,Urologkirurgi,Häggman, M., Department of Urology, University Hospital, Uppsala, Sweden
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- Andersson, Swen-Olof (författare)
- Örebro universitet,Hälsoakademin,Department of Urology, Örebro University Hospital, Örebro, Sweden
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- Bratell, Stefan (författare)
- Department of Urology, Borås Hospital, Borås, Sweden
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- Spångberg, Anders (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Urologi,Hälsouniversitetet,Urologiska kliniken i Östergötland
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- Palmgren, Juni (författare)
- Stockholms universitet,Karolinska Institutet,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Matematiska institutionen,Palmgren
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- Adami, Hans-Olov (författare)
- Karolinska Institutet,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
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- Johansson, Jan-Erik (författare)
- Örebro universitet,Hälsoakademin,Department of Urology, Örebro University Hospital, Örebro, Sweden, Center for Assessment of Medical Technology, Örebro University Hospital, Örebro, Sweden
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Lindeborg, T. (författare)
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Einarsson, G. (författare)
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Ekman, P. (författare)
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Wijkström, H. (författare)
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Karlberg, L. (författare)
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Hagberg, G. (författare)
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- de la Torre, Manuel (författare)
- Uppsala universitet,Institutionen för genetik och patologi
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- Hamberg, Hans (författare)
- Uppsala universitet,Institutionen för genetik och patologi
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- Lindgren, Anders (författare)
- Uppsala universitet,Institutionen för genetik och patologi
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Mavadati, E. (författare)
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Gobén, B. (författare)
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Pettersson, I. (författare)
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Varenhorst, E. (författare)
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Norlén, B.J. (författare)
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(creator_code:org_t)
- 2008-08-11
- 2008
- Engelska.
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press. - 0027-8874 .- 1460-2105. ; 100:16, s. 1144-1154
- Relaterad länk:
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https://doi.org/10.1...
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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http://kipublication...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- BACKGROUND: The benefit of radical prostatectomy in patients with early prostate cancer has been assessed in only one randomized trial. In 2005, we reported that radical prostatectomy improved prostate cancer survival compared with watchful waiting after a median of 8.2 years of follow-up. We now report results after 3 more years of follow-up.METHODS: From October 1, 1989, through February 28, 1999, 695 men with clinically localized prostate cancer were randomly assigned to radical prostatectomy (n = 347) or watchful waiting (n = 348). Follow-up was complete through December 31, 2006, with histopathologic review and blinded evaluation of causes of death. Relative risks (RRs) were estimated using the Cox proportional hazards model. Statistical tests were two-sided.RESULTS: During a median of 10.8 years of follow-up (range = 3 weeks to 17.2 years), 137 men in the surgery group and 156 in the watchful waiting group died (P = .09). For 47 of the 347 men (13.5%) who were randomly assigned to surgery and 68 of the 348 men (19.5%) who were not, death was due to prostate cancer. The difference in cumulative incidence of death due to prostate cancer remained stable after about 10 years of follow-up. At 12 years, 12.5% of the surgery group and 17.9% of the watchful waiting group had died of prostate cancer (difference = 5.4%, 95% confidence interval [CI] = 0.2 to 11.1%), for a relative risk of 0.65 (95% CI = 0.45 to 0.94; P = .03). The difference in cumulative incidence of distant metastases did not increase beyond 10 years of follow-up. At 12 years, 19.3% of men in the surgery group and 26% of men in the watchful waiting group had been diagnosed with distant metastases (difference = 6.7%, 95% CI = 0.2 to 13.2%), for a relative risk of 0.65 (95% CI = 0.47 to 0.88; P = .006). Among men who underwent radical prostatectomy, those with extracapsular tumor growth had 14 times the risk of prostate cancer death as those without it (RR = 14.2, 95% CI = 3.3 to 61.8; P < .001).CONCLUSION: Radical prostatectomy reduces prostate cancer mortality and risk of metastases with little or no further increase in benefit 10 or more years after surgery.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Aged
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Odds Ratio
- Proportional Hazards Models
- Prostate-Specific Antigen/blood
- Prostatectomy/methods
- Prostatic Neoplasms/immunology/*mortality/pathology/*surgery
- Research Design
- Risk Assessment
- Scandinavia/epidemiology
- Time Factors
- MEDICINE
- MEDICIN
- Surgery
- Kirurgi
- Oncology
- Onkologi
- Onkologi
- Oncology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Bill-Axelson, An ...
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Holmberg, Lars
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Filén, Frej
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Ruutu, Mirja
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Garmo, Hans
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Busch, Christer
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visa fler...
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Nordling, Stig
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Häggman, Michael
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Andersson, Swen- ...
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Bratell, Stefan
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Spångberg, Ander ...
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Palmgren, Juni
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Adami, Hans-Olov
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Johansson, Jan-E ...
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Lindeborg, T.
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Einarsson, G.
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Ekman, P.
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Wijkström, H.
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Karlberg, L.
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Hagberg, G.
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de la Torre, Man ...
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Hamberg, Hans
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Lindgren, Anders
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Mavadati, E.
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Gobén, B.
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Pettersson, I.
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Varenhorst, E.
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Norlén, B.J.
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Cancer och onkol ...
- Artiklar i publikationen
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Journal of the N ...
- Av lärosätet
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Örebro universitet
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Uppsala universitet
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Karolinska Institutet
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Linköpings universitet
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Stockholms universitet