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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 orcid ; 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
; ; ; ; and
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 Inc.
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
2016-04-01 12:17:02
date last changed
2022-12-09 08:22:05
@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}},
  keywords     = {{radical prostatectomy; PSA doubling time; prostate cancer; surveillance}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{170--174}},
  publisher    = {{John Wiley & Sons Inc.}},
  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}},
  doi          = {{10.1002/ijc.22161}},
  volume       = {{120}},
  year         = {{2007}},
}