Currently used criteria for active surveillance in men with low-risk prostate cancer: an analysis of pathologic features.
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Currently used criteria for active surveillance in men with low-risk prostate cancer: an analysis of pathologic features. / Nazareno, Suardi; Capitanio, Umberto; Chun, Felix; Graefen, Markus; Perrotte, Paul; Schlomm, Thorsten; Haese, Alexander; Huland, Hartwig; Erbersdobler, Andreas; Montorsi, Francesco; Karakiewicz, Pierre I.
in: CANCER-AM CANCER SOC, Jahrgang 113, Nr. 8, 8, 2008, S. 2068-2072.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Currently used criteria for active surveillance in men with low-risk prostate cancer: an analysis of pathologic features.
AU - Nazareno, Suardi
AU - Capitanio, Umberto
AU - Chun, Felix
AU - Graefen, Markus
AU - Perrotte, Paul
AU - Schlomm, Thorsten
AU - Haese, Alexander
AU - Huland, Hartwig
AU - Erbersdobler, Andreas
AU - Montorsi, Francesco
AU - Karakiewicz, Pierre I
PY - 2008
Y1 - 2008
N2 - BACKGROUND: Active surveillance (AS) represents a treatment option for select patients with low-risk, organ-confined prostate cancer (PCa). In this report, the authors addressed the rates of misclassification associated with the use of 5 different clinical criteria for AS. Misclassification was defined as the presence of either nonorgan-confined disease or high-grade PCa. METHODS: Between 1992 and 2007, 4885 patients underwent radical prostatectomy (RP) at 1 of 2 European academic centers, and the patients were identified who fulfilled the criteria for AS according to 5 different investigational groups (Hardie et al, Roemeling et al, Choo et al, Klotz, and D'Amico and Coleman). Statistics targeted the rates of misclassification for each of the 5 definitions. RESULTS: Four thousand three hundred eight patients, 4047 patients, 3993 patients, 2455 patients, and 2345 patients fulfilled the AS criteria of Hardie et al, Roemeling et al, Choo et al, Klotz, and D'Amico and Coleman, respectively. Extracapsular extension was reported in 13.5% to 26% of patients, and seminal vesicle invasion was reported in 2.9% to 8.2% of patients. When PCa with Gleason scores from 8 to 10 at RP was considered high grade, the misclassification rates were 27%, 25%, 25%, 15%, and 14% for the 5 studies, respectively. Conversely, when PCa with Gleason scores from 7 to 10 was considered high grade, the misclassification rates increased to 56%, 55%, 45%, 42%, and 39%, respectively. CONCLUSIONS: The currently available AS criteria are limited by a high rate of misclassification. The use of more selective AS criteria may reduce the rate of misclassification but also may reduce significantly the percentage of patients who may be considered for AS.
AB - BACKGROUND: Active surveillance (AS) represents a treatment option for select patients with low-risk, organ-confined prostate cancer (PCa). In this report, the authors addressed the rates of misclassification associated with the use of 5 different clinical criteria for AS. Misclassification was defined as the presence of either nonorgan-confined disease or high-grade PCa. METHODS: Between 1992 and 2007, 4885 patients underwent radical prostatectomy (RP) at 1 of 2 European academic centers, and the patients were identified who fulfilled the criteria for AS according to 5 different investigational groups (Hardie et al, Roemeling et al, Choo et al, Klotz, and D'Amico and Coleman). Statistics targeted the rates of misclassification for each of the 5 definitions. RESULTS: Four thousand three hundred eight patients, 4047 patients, 3993 patients, 2455 patients, and 2345 patients fulfilled the AS criteria of Hardie et al, Roemeling et al, Choo et al, Klotz, and D'Amico and Coleman, respectively. Extracapsular extension was reported in 13.5% to 26% of patients, and seminal vesicle invasion was reported in 2.9% to 8.2% of patients. When PCa with Gleason scores from 8 to 10 at RP was considered high grade, the misclassification rates were 27%, 25%, 25%, 15%, and 14% for the 5 studies, respectively. Conversely, when PCa with Gleason scores from 7 to 10 was considered high grade, the misclassification rates increased to 56%, 55%, 45%, 42%, and 39%, respectively. CONCLUSIONS: The currently available AS criteria are limited by a high rate of misclassification. The use of more selective AS criteria may reduce the rate of misclassification but also may reduce significantly the percentage of patients who may be considered for AS.
M3 - SCORING: Zeitschriftenaufsatz
VL - 113
SP - 2068
EP - 2072
JO - CANCER-AM CANCER SOC
JF - CANCER-AM CANCER SOC
SN - 0008-543X
IS - 8
M1 - 8
ER -