Outcomes of Biopsy Grade Group 1 Prostate Cancer Diagnosis in the Danish Population.

Autor: Stroomberg HV; Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: hein.vincent.stroomberg@regionh.dk., Larsen SB; Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Survivorship and Inequality in Cancer, Danish Cancer Society Research Centre, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Kjær Nielsen T; Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Helgstrand JT; Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Brasso K; Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Røder A; Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: European urology oncology [Eur Urol Oncol] 2024 Aug; Vol. 7 (4), pp. 770-777. Date of Electronic Publication: 2023 Oct 25.
DOI: 10.1016/j.euo.2023.10.005
Abstrakt: Background: Debate regarding a nomenclature change for grade group 1 (GG 1) prostate cancer to noncancer has been revived, as this could be a powerful tool in reducing the overtreatment of indolent disease.
Objective: To describe outcomes for all men diagnosed with GG 1 prostate cancer in the Danish population, with a focus on men followed conservatively.
Design, Setting, and Participants: This was a population-based observational study using data from the Danish Prostate Registry.
Outcome Measurements and Statistical Analysis: We measured the cumulative incidence of curative treatment, endocrine treatment, and cause-specific mortality.
Results and Limitations: The cumulative incidence of endocrine therapy at 10 yr was 5.3% (95% confidence interval [CI] 4.3-6.3%) for men with initial active surveillance and 21% (95% CI 19-23%) for men with initial watchful waiting for localized GG 1. In the GG1 cohort, the prostate cancer-specific mortality rate at 15 yr was 14% (95 CI% 11-16%) for men on watchful waiting, 10% (95 CI% 6.7-14%) for men with prostate-specific antigen <10 ng/ml on watchful waiting, and 16% (95 CI% 13-19%) for men who did not receive curative-intent treatment or histological assessment. The study is limited by the historic nature of the observations over a period during which diagnostic procedures and treatments have evolved.
Conclusions: GG 1 cancer can lead to disease-specific mortality in men with localized prostate cancer, and changing the nomenclature for all men may lead to undertreatment.
Patient Summary: Key opinion leaders have suggested that prostate cancers of Gleason grade group 1 (GG 1) should be renamed as noncancer to reduce overtreatment. The argument is that low-grade cancer does not metastasize. However, our nationwide population-based study showed that death from prostate cancer can occur in some men diagnosed with GG 1 disease. These men should be considered in discussions on changing the name for GG 1 prostate cancer.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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