Risk of Metastasis in Men with Grade Group 2 Prostate Cancer Managed with Active Surveillance at a Tertiary Cancer Center
| Autor: | Samson W. Fine, Maha Mamoor, Andrew J. Vickers, Ricardo Alvim, Behfar Ehdaie, Victor E. Reuter, Sigrid Carlsson, James A. Eastham, Karim Touijer, Daniel Sjöberg, Hebert Alberto Vargas, Vincent P. Laudone, Nicole Benfante, Michal Wiseman, Peter T. Scardino |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult Male Risk medicine.medical_specialty Urology medicine.medical_treatment Biopsy 030232 urology & nephrology Disease Kaplan-Meier Estimate Article Metastasis Tertiary Care Centers 03 medical and health sciences Prostate cancer 0302 clinical medicine Internal medicine Outcome Assessment Health Care medicine Humans Neoplasm Metastasis Watchful Waiting Aged Digital Rectal Examination Retrospective Studies Aged 80 and over business.industry Cancer Prostatic Neoplasms Middle Aged medicine.disease Magnetic Resonance Imaging humanities Neoplasm Grading business Watchful waiting Follow-Up Studies |
| Zdroj: | J Urol |
| ISSN: | 1527-3792 |
| Popis: | PURPOSE: To study the risk of metastatic prostate cancer development in men with Grade Group 2 disease being managed with active surveillance (AS) at Memorial Sloan Kettering Cancer Center. MATERIALS AND METHODS: 219 men with Grade Group 2 prostate cancer were managed with AS between 2000–2017. Biopsy was performed every 2–3 years or upon changes in magnetic resonance imaging, prostate-specific antigen (PSA) level, or digital rectal examination. The primary outcome was development of distant metastasis. The Kaplan-Meier method was used to estimate treatment-free survival. RESULTS: The median age at diagnosis was 67 years (IQR 61, 72), the median PSA was 5 ng/mL (IQR 4, 7), and most patients (69%) had non-palpable disease. During follow-up, 64 men received treatment: 36/64 (56%) radical prostatectomy; 20/64 (31%) radiotherapy; 3/64 (5%) hormone therapy; and 5/64 (8%) focal therapy. Of the 36 patients who underwent radical prostatectomy, 32/36 (89%) had Grade Group 2 disease on pathology and 4/36 (11%) had Grade Group 3. Treatment-free survival was 61% (95% CI 52%–70%) at 5 years and 49% (95% CI 37%–60%) at 10 years. Three men experienced biochemical recurrence, no men developed distant metastasis, and no men died of prostate cancer during the follow-up. The median follow-up was 3.1 years (IQR 1.9, 4.9). CONCLUSIONS: AS appears to be a safe initial management strategy in the short term for carefully selected and closely monitored men with Grade Group 2 prostate cancer managed at a tertiary cancer center. Definitive conclusions await further follow-up. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|