Re: Grace L. Lu-Yao, Peter C. Albertsen, Dirk F. Moore, Yong Lin, Robert S. DiPaola, Siu-Long Yao. Fifteen-year Outcomes Following Conservative Management Among Men aged 65 Years or Older with Localized Prostate Cancer. Eur Urol 2015;68:805–11

Autor: Manfred P. Wirth, Michael Froehner, Rainer Koch
Rok vydání: 2016
Předmět:
Zdroj: European Urology. 69:e130
ISSN: 0302-2838
DOI: 10.1016/j.eururo.2015.11.032
Popis: In a meritorious study, Lu-Yao et al [1] presented long-term outcome data in a large sample of initially conservatively treated patients with prostate cancer diagnosed between 1992 and 2009. With the observed 15-yr prostate cancerspecific mortality rate of 5.7% (95% confidence interval [CI] 3.7–8.0%), the authors concluded that elderly men with low-grade (ie, Gleason score 5–7) disease are unlikely to benefit from radical prostatectomy and should prefer active surveillance or conservative management as initial treatment [1]. Between 1992 and 2007, 2961 consecutive patients underwent radical prostatectomy at our institution. The median follow-up was 9.8 yr. A total of 1468 patients were aged 65.0–74.9 yr. In those patients, the 15-yr prostate cancer-specific mortality rate (all tumor grades) was 5.2% (95% CI 3.7–6.7%) and the 15-yr competing mortality rate was 29.8% (95% CI 25.5–34.0%). Compared with the 15-yr competing mortality rates of roughly 50% in the initially not curatively treated patients in the study by Lu-Yao et al [1], the competing mortality rate in our sample of elderly patients selected for radical prostatectomy was considerably lower indicating that this relatively healthy population will remain clearly longer at risk of dying from prostate cancer particularly if the tumor was left untreated. With untreated well or moderately differentiated prostate cancer, in the long run, prostate cancer-specific mortality
Databáze: OpenAIRE
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