Long-term outcome among men with conservatively treated localised prostate cancer.
Long-term outcome among men with conservatively treated localised prostate cancer.
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接受保守治疗的局限性前列腺癌男性的长期结果。
DOI：
10.1038/sj.bjc.6603411
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发表时间：
2006-11-06
影响因子：
8.8
通讯作者：
Scardino, P.
中科院分区：
文献类型：
--
作者：
Cuzick, J.;Fisher, G.;Kattan, M. W.;Berney, D.;Oliver, T.;Foster, C. S.;Moller, H.;Reuter, V.;Fearn, P.;Eastham, J.;Scardino, P.
临床局限性前列腺癌的最佳管理提出了独特的挑战，因为它的高度可变，往往是惰性的自然史。迫切需要更准确地预测其自然史，以避免不必要的治疗。回顾了1990年至1996年期间在英国被诊断为临床局限性前列腺癌的男性的医疗记录，以确定那些接受保守治疗的患者，在病理诊断时年龄在76岁以下，并且具有基线前列腺特异性抗原（PSA）测量值。对诊断性活检标本进行集中审查，以分配主要和次要Gleason分级。主要终点是前列腺癌死亡，并构建多变量模型来确定其最佳预测因素。共确定了2333例合格患者。最重要的预后因素是Gleason评分和基线PSA水平。这些因素在很大程度上是独立的，并且共同贡献的预测能力比单独的任何一个都要大。通过针吸活检或经尿道前列腺切除术（TURP）芯片确定的疾病临床分期和程度提供了一些额外的预后信息。总之，使用Gleason评分和PSA水平的模型确定了三个亚组，分别占队列的17%、50%和33%，10年前列腺癌特异性死亡率分别为<10%、10- 30%和> 30%。这种分类是对以前仅使用Gleason评分的分类的实质性改进，但需要更好的标记物来更准确地预测中间组患者的生存率。
Optimal management of clinically localised prostate cancer presents unique challenges, because of its highly variable and often indolent natural history. There is an urgent need to predict more accurately its natural history, in order to avoid unnecessary treatment. Medical records of men diagnosed with clinically localised prostate cancer, in the UK, between 1990 and 1996 were reviewed to identify those who were conservatively treated, under age 76 years at the time of pathological diagnosis and had a baseline prostate-specific antigen (PSA) measurement. Diagnostic biopsy specimens were centrally reviewed to assign primary and secondary Gleason grades. The primary end point was death from prostate cancer and multivariate models were constructed to determine its best predictors. A total of 2333 eligible patients were identified. The most important prognostic factors were Gleason score and baseline PSA level. These factors were largely independent and together, contributed substantially more predictive power than either one alone. Clinical stage and extent of disease determined, either from needle biopsy or transurethral resection of the prostate (TURP) chips, provided some additional prognostic information. In conclusion, a model using Gleason score and PSA level identified three subgroups comprising 17, 50, and 33% of the cohort with a 10-year prostate cancer specific mortality of <10, 10–30, and >30%, respectively. This classification is a substantial improvement on previous ones using only Gleason score, but better markers are needed to predict survival more accurately in the intermediate group of patients.
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影响因子：
120.7
作者：
Albertsen, PC;Hanley, JA;Barry, MJ
通讯作者：
Barry, MJ
影响因子：
6.4
作者：
BRESLOW, N;CHAN, CW;TULINIUS, H
通讯作者：
TULINIUS, H
影响因子：
23.4
作者：
Evans, HS;Moller, H
通讯作者：
Moller, H
影响因子：
10.3
作者：
Kattan, MW;Eastham, JA;Scardino, PT
通讯作者：
Scardino, PT
影响因子：
6.6
作者：
Kondylis, FI;Moriarty, RP;Schellhammer, PF
通讯作者：
Schellhammer, PF