Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer
Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer
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DOI：
10.1001/jama.280.11.975
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发表时间：
1998-09-16
影响因子：
120.7
通讯作者：
Barry, MJ
中科院分区：
文献类型：
--
作者：
Albertsen, PC;Hanley, JA;Barry, MJ
上下文。-局限性前列腺癌患者的适当治疗方法尚不确定。在临床试验结果出来之前，男性和他们的医生需要指导。目的：对临床诊断为局限性前列腺癌且接受保守治疗的男性，根据诊断年龄和组织学结果分层的竞争性风险分析来估计生存率。-回顾性队列研究，背景。-康涅狄格肿瘤登记处。-在1971年至1984年期间，共有767名确诊为局限性前列腺癌的男性，年龄在55岁至74岁之间，要么未接受治疗，要么接受了立即或延迟激素治疗，并在诊断后随访10至20年。主要结果测量。-前列腺癌或其他竞争危险死亡概率的估计，结果。Gleason评分为2 ~ 4、5、6、7和8 ~ 10的前列腺癌患者，根据诊断年龄的不同，15年内死于前列腺癌的概率分别为4% ~ 7%、6% ~ 11%、18% ~ 30%、42% ~ 70%和60% ~ 87%。并肩的前列腺活检标本显示格里森评分2到4疾病面临一个最小的风险在15年内死于前列腺癌的诊断,相反,男人的活检标本显示格里森评分7到10死于前列腺癌疾病面临高风险的保守治疗时,即使癌症诊断直到74岁,男性格里森评分5或6肿瘤面临温和慢慢死于前列腺癌的风险增加在至少15年的随访。
Context.-The appropriate therapy for men with localized prostate cancer is uncertain. Until results of clinical trials are available, men and their physicians need guidance.Objective.-To estimate survival based on a competing risk analysis stratified by age at diagnosis and histologic findings for men diagnosed as having clinically localized prostate cancer and who were managed conservatively.Design.-Retrospective cohort study,Setting.-Connecticut Tumor Registry.Patients.-A total of 767 men with localized prostate cancer diagnosed between 1971 and 1984, aged 55 to 74 years at diagnosis, either not treated or treated with immediate pr delayed hormonal therapy, and followed up for 10 to 20 years after diagnosis.Main Outcome Measures.-Estimates of the probability of dying from prostate cancer or other competing hazards,Results.-Men with tumors that have Gleason scores of 2 to 4, 5, 6, 7, and 8 to 10 face a 4% to 7%, 6% to 11%, 18% to 30%, 42% to 70%, and 60% to 87% chance, respectively, of dying from prostate cancer within 15 years of diagnosis depending on their age at diagnosis,Conclusions.-Men whose prostate biopsy specimens show Gleason score 2 to 4 disease face a minimal risk of death from prostate cancer within 15 years of diagnosis, Conversely, men whose biopsy specimens show Gleason score 7 to 10 disease face a high risk of death from prostate cancer when treated conservatively, even when cancer is diagnosed as late as age 74 years, Men with Gleason score 5 or 6 tumors face a modest risk of death from prostate cancer that increases slowly over at least 15 years of follow-up.