共查询到20条相似文献,搜索用时 26 毫秒
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Patel MI DeConcini DT Lopez-Corona E Ohori M Wheeler T Scardino PT 《The Journal of urology》2004,171(4):1520-1524
PURPOSE: We evaluated expectant management of prostate cancer with definitive treatment deferred until evidence of cancer progression in men with low risk, localized cancers. MATERIALS AND METHODS: We retrospectively reviewed prospectively entered data base records. Patients with low risk cancer who were eligible for definitive therapy but chose deferred management between 1984 and 2001 composed the cohort. Followup included regular evaluations to detect progression by prostate specific antigen (PSA), digital rectal examination, transrectal ultrasound and prostate biopsy. Objective progression was defined by a point scale of changes in prognostic factors. Definitive treatment was recommended in patients with objective progression. RESULTS: The cohort comprised 88 patients with clinical stages T1-2, NX0, M0 prostate cancer, a mean age of 65.3 years and a mean initial PSA of 5.9 ng/ml. Systematic biopsy, which was repeated after the initial diagnostic biopsy, showed no cancer in 61% of cases. During a median followup of 44 months 22 patients had progression. Factors that predicted progression were repeat biopsy showing cancer (p = 0.004) and initial PSA (p = 0.014). Actuarial 5 and 10-year progression-free probabilities were 67% and 55%, respectively. Of the 31 patients treated 17 underwent radical prostatectomy, 13 received radiation therapy and 1 received androgen ablation. Seven men who did not show objective progression were treated because of anxiety. Only 1 patient, who was treated with radiation therapy, had biochemical recurrence. CONCLUSIONS: Deferred therapy may be a feasible alternative to curative treatment in select patients with favorable, localized prostate cancer. About half of these patients remain free of progression at 10 years and definitive treatment appeared effective in those with progression. Absent cancer on repeat needle biopsy identified cases highly unlikely to progress. 相似文献
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Testosterone treatment is not associated with increased risk of prostate cancer or worsening of lower urinary tract symptoms: prostate health outcomes in the Registry of Hypogonadism in Men 下载免费PDF全文
Frans M.J. Debruyne Hermann M. Behre Claus G. Roehrborn Mario Maggi Frederick C.W. Wu Fritz H. Schröder Thomas Hugh Jones Hartmut Porst Geoffrey Hackett Olivia A. Wheaton Antonio Martin‐Morales Eric Meuleman Glenn R. Cunningham Hozefa A. Divan Raymond C. Rosen the RHYME Investigators 《BJU international》2017,119(2):216-224
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PURPOSE: We determined the long-term clinical significance of primary Gleason pattern in patients with Gleason score 7 prostate cancer. MATERIALS AND METHODS: We reviewed the records of all patients who underwent bilateral pelvic lymph node dissection and radical retropubic prostatectomy for Gleason score 7 prostate cancer at our institution. All patients who underwent adjuvant hormonal or radiation therapy were excluded from analysis. Patients were monitored for biochemical failure, that is PSA progression, systemic recurrence and cancer specific survival. RESULTS: We identified 1,688 patients who met admission criteria, of whom 1,256 (74.4%) had primary Gleason pattern 3 and 432 (25.6%) had primary Gleason pattern 4. Median followup was 6.9 years. At 10 years primary Gleason pattern 3 was associated with increased biochemical recurrence-free survival (48% vs 38%, p <0.001), lower systemic recurrence (8% vs 15%, p <0.001) and higher cancer specific survival (97% vs 93%, p = 0.013) for Gleason primary grades 3 and 4, respectively. All of these end points remained significant on multivariate analysis when controlling for preoperative PSA, seminal vesicle involvement, margin status, DNA ploidy and TNM staging. PSA doubling time was shorter in patients with primary Gleason pattern 4 (1.64 vs 1.01 years). Systemic recurrence and cancer specific survival were associated with a PSA doubling time of less than 1 year. CONCLUSIONS: Gleason score 7 prostate cancer is a heterogeneous entity. We should continue to stratify patients according to primary Gleason pattern. Patients with Gleason score 4 + 3 prostate cancer have more aggressive disease and experience higher rates of biochemical failure, systemic recurrence and cancer specific death. 相似文献
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Prasanna Sooriakumaran Caroline Wilson Ines Rombach Neelam Hassanali Jonathan Aning Alastair D. Lamb Paul Cathcart Christopher Eden Imran Ahmad Prabhakar Rajan Ashwin Sridhar Richard J. Bryant Oussama Elhage Jonathan Cook Hing Leung Naeem Soomro John Kelly Senthil Nathan Jenny L. Donovan Freddie C. Hamdy 《BJU international》2022,130(1):43-53
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Sissal Sigmundsdóttir Djurhuus Casper Simonsen Birgitte Grønkær Toft Simon Nørskov Thomsen Sabrina Wielsøe Martin Andreas Røder Thomas Hasselager Peter Busch Østergren Henrik Jakobsen Bente Klarlund Pedersen Pernille Hojman Klaus Brasso Jesper Frank Christensen 《BJU international》2023,131(1):116-124
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Charlotte Fenioux Christophe Louvet Emilie Charton Francois Rozet Stanislas Ropert Dominique Prapotnich Eric Barret Rafael Sanchez-Salas Annick Mombet Nathalie Cathala Marie-Liesse Joulia Jean-Luc Molitor Julie Henriques Franck Bonnetain Xavier Cathelineau Mostefa Bennamoun 《BJU international》2019,123(2):300-306
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Armando Stabile Clement Orczyk Feargus Hosking-Jervis Francesco Giganti Manit Arya Richard G. Hindley Louise Dickinson Clare Allen Shonit Punwani Charles Jameson Alex Freeman Neil McCartan Francesco Montorsi Alberto Briganti Hashim U. Ahmed Mark Emberton Caroline M. Moore 《BJU international》2019,124(3):431-440
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Frederik Wessels Max Schmitt Eva Krieghoff-Henning Tanja Jutzi Thomas S. Worst Frank Waldbillig Manuel Neuberger Roman C. Maron Matthias Steeg Timo Gaiser Achim Hekler Jochen S. Utikal Christof von Kalle Stefan Fröhling Maurice S. Michel Philipp Nuhn Titus J. Brinker 《BJU international》2021,128(3):352-360