Insignificant disease among men with intermediate-risk prostate cancer Journal Article
| Authors: | Hong, S. K.; Vertosick, E.; Sjoberg, D. D.; Scardino, P. T.; Eastham, J. A. |
| Article Title: | Insignificant disease among men with intermediate-risk prostate cancer |
| Abstract: | Purpose: A paucity of data exists on the insignificant disease potentially suitable for active surveillance (AS) among men with intermediate-risk prostate cancer (PCa). We tried to identify pathologically insignificant disease and its preoperative predictors in men who underwent radical prostatectomy (RP) for intermediate-risk PCa. Methods: We analyzed data of 1,630 men who underwent RP for intermediate-risk disease. Total tumor volume (TTV) data were available in 332 men. We examined factors associated with classically defined pathologically insignificant cancer (organ-confined disease with TTV ≤0.5 ml with no Gleason pattern 4 or 5) and pathologically favorable cancer (organ-confined disease with no Gleason pattern 4 or 5) potentially suitable for AS. Decision curve analysis was used to assess clinical utility of a multivariable model including preoperative variables for predicting pathologically unfavorable cancer. Results: In the entire cohort, 221 of 1,630 (13.6 %) total patients had pathologically favorable cancer. Among 332 patients with TTV data available, 26 (7.8 %) had classically defined pathologically insignificant cancer. Between threshold probabilities of 20 and 40 %, decision curve analysis demonstrated that using multivariable model to identify AS candidates would not provide any benefit over simply treating all men who have intermediate-risk disease with RP. Conclusion: Although a minority of patients with intermediate-risk disease may harbor pathologically favorable or insignificant cancer, currently available conventional tools are not sufficiently able to identify those patients. |
| Keywords: | prediction; prostatic neoplasms; prostate; intermediate risk; insignificant |
| Journal Title: | World Journal of Urology |
| Volume: | 32 |
| Issue: | 6 |
| ISSN: | 0724-4983 |
| Publisher: | Springer |
| Date Published: | 2014-12-01 |
| Start Page: | 1417 |
| End Page: | 1421 |
| Language: | English |
| DOI: | 10.1007/s00345-014-1413-3 |
| PROVIDER: | scopus |
| PUBMED: | 25261260 |
| PMCID: | PMC4558555 |
| DOI/URL: | |
| Notes: | Export Date: 2 January 2015 -- Source: Scopus |
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