Is it appropriate to conduct conventional active surveillance for Asian men with low-risk prostate cancer?
Is it appropriate to conduct conventional active surveillance for Asian men with low-risk prostate cancer?
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对患有低风险前列腺癌的亚洲男性进行常规主动监测是否合适？
DOI：
10.1007/s11255-016-1287-y
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发表时间：
2016-04
影响因子：
2
通讯作者：
Liang Chaozhao
中科院分区：
文献类型：
--
作者：
Xu Ming;Zhang Li;Liang Chaozhao
P<；0.001；韩国与AA相比，OR=1.59，P=0.009)。具体来说，升级到高级别PCa(格里森评分4+3或更高)(韩国人=15.7%对高加索人=4.4%和AA=2.9%，P<；0.001)和降级到进展期Pca(Pt3或更高)(韩国人=16.2%对高加索人=4.9%和非裔美国人=8.0%，P<；0.001)在韩国男性中比低风险Pca的西方男性更常见[4]。因此，与西方国家的男性相比，患有低风险PCa的亚洲男性更有可能发展为高级别或晚期PCa，这进一步促使我们怀疑传统PCa的合理性，特别是在患有低风险PCs的亚洲男性中。这一提出的担忧也得到了其他研究的支持。例如，一项最新的多中心研究发现，在324名低风险前列腺癌患者中，31名(9.6%)的患者在术后至少升级到PT3,142名(43.8%)的患者至少升级到Gleason评分7,154名(47.5%)的患者术后升级或降级[5]。另一项研究调查了符合主动监测条件的日本男性前列腺癌根治术后的病理结果，观察到40名患者(47.6%)(临床上分别被归类为低风险、中风险和高风险)的≥评分为7，8名患者(9.5%)(所有患者均被归类为低风险)≥PT3[6]，再次验证了重新评估亚洲低风险前列腺癌患者是否适合接受传统的主动监测。尽管一些不一致的结果使这一问题具有争议性和复杂性(表1)，但最近，Zlotta等人[7]通过尸检比较了亚洲人和高加索人的PCa患病率，随后发现Gleason评分为7或更高的患者分别占全部患者的23.1%和51.4%
P< 0.001; Korean vs. AA, OR= 1.59, P= 0.009) than Western men with localized PCa. Specifically, both upgrading to high-grade PCa (Gleason score 4+ 3 or higher)(Korean= 15.7% vs. Caucasian= 4.4% and AA= 2.9%, P< 0.001) and upstaging to advancedstage PCa (pT3 or higher)(Korean= 16.2% vs. Caucasian= 4.9% and African American= 8.0%, P< 0.001) were more frequently found in Korean men than in Western men with low-risk PCa [4]. Accordingly, compared with men in Western countries, Asian men with low-risk PCa are more likely to develop high-grade or advancedstage PCa, which further promotes us to suspect the rationality of conventional AS specifically in Asian men with low-risk PCa.The raised concern has been also supported by other previous studies. For instance, a most recent multicenter study has found that of the 324 patients with low-risk prostate cancer, 31 (9.6%) were upstaged to at least pT3, 142 (43.8%) were upgraded to at least Gleason score 7, and 154 (47.5%) were either upgraded or upstaged postoperatively in Korea [5]. Another study has investigated the pathological outcomes of Japanese men eligible for active surveillance after radical prostatectomy and observed that 40 patients (47.6%)(clinically, 37 patients, 2 patients and 1 patient were classified as low, intermediate and high risk, respectively) had Gleason score of≥ 7, and eight patients (9.5%)(All the patients were classified as low-risk) had≥ pT3 [6], again verifying the necessity to reassess whether Asian men with low-risk prostate cancer are suitable for undergoing conventional active surveillance. Whereas some inconsistent results made the issue controversial and complicated (Table 1), very recently, Zlotta et al.[7] have compared the prevalence of PCa by autopsy in Asian and Caucasian men and subsequently found Gleason score 7 or higher accounted for 23.1 and 51.4% of all
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影响因子：
45.3
作者：
Siddiqui, Mohummad Minhaj;Wilson, Kathryn M.;Mucci, Lorelei A.
通讯作者：
Mucci, Lorelei A.
影响因子：
3.3
作者：
Takahiro Inoue;H. Kinoshita;H. Inui;Yoshihiro Komai;M. Nakagawa;N. Oguchi;G. Kawa;M. Sugi;C. Ohe;Chika Miyasaka;Yorika Nakano;N. Sakaida;Y. Uemura;T. Matsuda
通讯作者：
Takahiro Inoue;H. Kinoshita;H. Inui;Yoshihiro Komai;M. Nakagawa;N. Oguchi;G. Kawa;M. Sugi;C. Ohe;Chika Miyasaka;Yorika Nakano;N. Sakaida;Y. Uemura;T. Matsuda
影响因子：
2.9
作者：
Hwang K;Miner M
通讯作者：
Miner M
影响因子：
10.3
作者：
Zlotta, Alexandre R.;Egawa, Shin;van der Kwast, Theodorus H.
通讯作者：
van der Kwast, Theodorus H.
DOI：
10.1016/j.urolonc.2015.08.004
发表时间：
2016-01-01
影响因子：
2.7
作者：
Jeong, In Gab;Dajani, Daoud;Ro, Jae Y.
通讯作者：
Ro, Jae Y.