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PSA doubling time predicts the outcome after active surveillance in screening-detected prostate cancer: Results from the European randomized study of screening for prostate cancer, Sweden section

Ali, Khatami; Gunnar, Aus; Jan-Erik, Damber; Lilja, Hans LU ; Par, Lodding and Jonas, Hugosson (2007) In International Journal of Cancer 120(1). p.170-174
Abstract
This study reports the outcome of active surveillance in men with PSA screening-detected prostate cancer (PC), and PSA doubling time (PSADT) was evaluated as a predictor of selecting patients to active treatment or surveillance. On December 31, 1994, 10,000 men were randomized to biennial PSA testing. Through to December 2004, a total of 660 men were diagnosed with PC, of whom 270 managed with initial surveillance. Of these 270 patients, 104 (39%) received active treatment during follow-up, 70 radical prostatectomy, 24 radiation and 10 endocrine treatment. Those who received active treatment during follow-up (mean 63 months) were significantly younger (62.6 vs. 65.5 years, p < 0.0001) and had a shorter PSADT (3.7 vs. 12 years, p <... (More)
This study reports the outcome of active surveillance in men with PSA screening-detected prostate cancer (PC), and PSA doubling time (PSADT) was evaluated as a predictor of selecting patients to active treatment or surveillance. On December 31, 1994, 10,000 men were randomized to biennial PSA testing. Through to December 2004, a total of 660 men were diagnosed with PC, of whom 270 managed with initial surveillance. Of these 270 patients, 104 (39%) received active treatment during follow-up, 70 radical prostatectomy, 24 radiation and 10 endocrine treatment. Those who received active treatment during follow-up (mean 63 months) were significantly younger (62.6 vs. 65.5 years, p < 0.0001) and had a shorter PSADT (3.7 vs. 12 years, p < 0.0001). PSA relapse was observed in 9 of 70 patients who received RRP during a mean follow-up of 37 months. Seven of these nine PSA relapses were in the patients with preoperative PSADT < 2 years. None of the 37 operated patients with a PSADT > 4 years had a PSA relapse. In a Cox regression analysis adjusted for PSA, ratio-free PSA and amount of cancer in biopsy, only the preoperative PSADT was statistically significant predictor of PSA relapse in p = 0.031. The optimal candidate for surveillance is a man with early, low-grade, low-stage PC and a PSADT > 4 years. In younger men with a PSADT of less than 4 years, surveillance does not seem to be a justified alternative, and patient should be informed about the risk with such an approach. (c) 2006 Wiley-Liss, Inc. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
radical prostatectomy, PSA doubling time, prostate cancer, surveillance
in
International Journal of Cancer
volume
120
issue
1
pages
170 - 174
publisher
John Wiley & Sons
external identifiers
  • wos:000242653300024
  • pmid:17013897
  • scopus:33845466234
ISSN
0020-7136
DOI
10.1002/ijc.22161
language
English
LU publication?
yes
id
9c5214c0-ba64-4b7a-ab17-67b9dcd94e33 (old id 683695)
date added to LUP
2007-12-04 18:00:52
date last changed
2017-10-01 03:51:35
@article{9c5214c0-ba64-4b7a-ab17-67b9dcd94e33,
  abstract     = {This study reports the outcome of active surveillance in men with PSA screening-detected prostate cancer (PC), and PSA doubling time (PSADT) was evaluated as a predictor of selecting patients to active treatment or surveillance. On December 31, 1994, 10,000 men were randomized to biennial PSA testing. Through to December 2004, a total of 660 men were diagnosed with PC, of whom 270 managed with initial surveillance. Of these 270 patients, 104 (39%) received active treatment during follow-up, 70 radical prostatectomy, 24 radiation and 10 endocrine treatment. Those who received active treatment during follow-up (mean 63 months) were significantly younger (62.6 vs. 65.5 years, p &lt; 0.0001) and had a shorter PSADT (3.7 vs. 12 years, p &lt; 0.0001). PSA relapse was observed in 9 of 70 patients who received RRP during a mean follow-up of 37 months. Seven of these nine PSA relapses were in the patients with preoperative PSADT &lt; 2 years. None of the 37 operated patients with a PSADT &gt; 4 years had a PSA relapse. In a Cox regression analysis adjusted for PSA, ratio-free PSA and amount of cancer in biopsy, only the preoperative PSADT was statistically significant predictor of PSA relapse in p = 0.031. The optimal candidate for surveillance is a man with early, low-grade, low-stage PC and a PSADT &gt; 4 years. In younger men with a PSADT of less than 4 years, surveillance does not seem to be a justified alternative, and patient should be informed about the risk with such an approach. (c) 2006 Wiley-Liss, Inc.},
  author       = {Ali, Khatami and Gunnar, Aus and Jan-Erik, Damber and Lilja, Hans and Par, Lodding and Jonas, Hugosson},
  issn         = {0020-7136},
  keyword      = {radical prostatectomy,PSA doubling time,prostate cancer,surveillance},
  language     = {eng},
  number       = {1},
  pages        = {170--174},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {PSA doubling time predicts the outcome after active surveillance in screening-detected prostate cancer: Results from the European randomized study of screening for prostate cancer, Sweden section},
  url          = {http://dx.doi.org/10.1002/ijc.22161},
  volume       = {120},
  year         = {2007},
}