Evaluation of predictors of unfavorable pathological features in men eligible for active surveillance using radical prostatectomy specimens: a multi-institutional study
| Autor: | Yoshiki Sugimura, Naoki Terada, Toshifumi Yano, Tomoyuki Shirase, Yoshiki Mikami, Gen Honjo, Takahiro Inoue, Osamu Ogawa, Takashi Kobayashi, Mutsushi Kawakita, Yoshiko Uemura, Kei Mizuno, Tadashi Matsuda, Keiji Ogura, Hideki Kanda, Hiroaki Kawanishi, Yukihiro Imai, Taizo Shiraishi, Hidefumi Kinoshita, Kazuhiro Okumura, Tomomi Kamba |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
Male Cancer Research medicine.medical_specialty Multivariate analysis medicine.medical_treatment 030232 urology & nephrology 03 medical and health sciences Prostate cancer 0302 clinical medicine Japan Internal medicine Biopsy medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) Aged Retrospective Studies Prostatectomy medicine.diagnostic_test business.industry Prostatic Neoplasms Retrospective cohort study General Medicine Prostate-Specific Antigen medicine.disease Prostate-specific antigen Logistic Models ROC Curve 030220 oncology & carcinogenesis Area Under Curve Multivariate Analysis Neoplasm Grading business Watchful waiting |
| Zdroj: | Japanese journal of clinical oncology. 46(12) |
| ISSN: | 1465-3621 |
| Popis: | OBJECTIVE Active surveillance has emerged as an alternative to immediate treatment in men with favorable-risk prostate cancer; however, consensus about defining the appropriate candidates is still lacking. To examine the factors predicting unfavorable pathology among active surveillance candidates, we assessed low-risk radical prostatectomy specimens. METHODS This retrospective study included 1753 men who had undergone radical prostatectomy at six independent institutions in Japan from 2005 to 2011. Patients who met the active surveillance criteria were categorized depending on the pathological features of the radical prostatectomy specimens. 'Reclassification' was defined as upstaging (≥pT3) or upgrading (radical prostatectomy Gleason score ≥7), and 'adverse pathology' was defined as pathological stage ≥pT3 or radical prostatectomy Gleason score ≥4 + 3. Multivariate analysis was used to analyze the preoperative factors for reclassification and adverse pathology. The rates of reclassification and adverse pathology were evaluated by classifying patients according to biopsy core numbers. RESULTS The active surveillance criteria were met by 284 cases. Reclassification was identified in 154 (54.2%) cases, while adverse pathology in 60 (21.1%) cases. Prostate-specific antigen density and percentage of positive cores were independently associated with reclassification and adverse pathology. The rates of reclassification and adverse pathology were significantly higher among patients with |
| Databáze: | OpenAIRE |
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