Abstract:
OBJECTIVE:• To report outcomes for patients with localized prostate cancer managed using a watchful waiting strategy at an American centre and to explore factors that have triggered intervention. PATIENTS AND METHODS:• From 1991 to 2005, 218 patients diagnosed with untreated localized prostate cancer were followed at Massachusetts General Hospital with prostate-specific antigen (PSA) monitoring and digital rectal examination (DRE). Re-biopsies were performed in 95 of the patients. • The median follow-up was 6.3 years. Clinical outcomes and features predicting intervention were examined. RESULTS:• At diagnosis, the median PSA level was 5.4 ng/mL. The Gleason score (GS) distribution was as follows: 95% with GS 6, 4% with GS 7, 1% with GS 8. The clinical T-stage distribution was as follows: 6% with T1a-b, 84% with T1c, 10% with T2. The median age was 71 years. • At 10 years, the overall survival was 79%, the cause-specific survival was 100%, the rate of distant metastasis was 5%, the rate of salvage androgen deprivation therapy was 15% and the rate of freedom from intervention (FFI) was 70%. • There was a PSA velocity of ≥ 2 ng/mL per year in 16% of patients, and a PSA doubling time of ≤ 3 years in 15% of patients. • Among the 95 re-biopsied men, the GS increased (grade progression) in 25% and the percentage of positive cores increased (volume progression) in 33%. • On multivariate analysis, only PSA doubling time and volume progression were independent predictors of FFI. CONCLUSIONS:• In the present series, watchful waiting was associated with low rates of intervention and cancer progression. • As PSA doubling time and volume progression were the main triggers for intervention, these will be incorporated into the centre's current active surveillance protocol.
journal_name
BJU Intjournal_title
BJU internationalauthors
Coen JJ,Feldman AS,Smith MR,Zietman ALdoi
10.1111/j.1464-410X.2010.09652.xsubject
Has Abstractpub_date
2011-05-01 00:00:00pages
1582-6issue
10eissn
1464-4096issn
1464-410Xjournal_volume
107pub_type
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2007.06771.x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:• To investigate the relationship between pretreatment testosterone levels and pathological specimen characteristics, by prospectively examining serum androgen concentrations in a well-studied cohort of patients who underwent radical prostatectomy (RP) for localized prostate cancer. PATIENTS AND METHODS:• A ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09816.x
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
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更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To develop a rat model of erectile dysfunction (ED) after cavernous nerve injury. MATERIALS AND METHODS:Given the great similarity between the anatomical structure of the cavernous nerve in rats and humans, 24 rats underwent dissections and the cavernous nerves were identified with the aid of an operating mi...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07760.x
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:To present our experience and outcome of consecutive laparoscopic renal biopsy over a 9-year period, as renal biopsy remains an important diagnostic procedure for evaluating proteinuria, haematuria and renal failure, but when percutaneous biopsy is contraindicated, a laparoscopic biopsy is an attractive opti...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04243.x
更新日期:2003-06-01 00:00:00
abstract:UNLABELLED:WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Prostate cancer has three known clinical risk factors: age, ethnicity and family history. Men's knowledge of prostate cancer is low. This study demonstrates that men rely on family and friends to learn about prostate cancer and help them interpret th...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11316.x
更新日期:2013-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10115.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of erectile dysfunction (ED) in a large cohort of Brazilian men who were screened for prostate cancer, and to determine risk factors in this population, as there are large cultural differences among countries in reporting the frequency of ED, and it is likely that the prevalence of...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.08562.x
更新日期:2009-10-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06424.x
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07558.x
更新日期:2008-08-01 00:00:00
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journal_title:BJU international
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410x.2004.04577.x
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pub_type: 杂志文章
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00057.x
更新日期:1999-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09775.x
更新日期:2011-07-01 00:00:00
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pub_type: 杂志文章
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journal_title:BJU international
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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更新日期:2004-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05741.x
更新日期:2005-11-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2005.05586.x
更新日期:2005-07-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00654.x
更新日期:2000-06-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11117.x
更新日期:2012-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06209.x
更新日期:2006-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11152.x
更新日期:2012-09-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and What does the study add? There have been few studies evaluating the prognostic value of epithelial-mesenchymal transition markers in renal cell carcinoma (RCC); therefore, the significance of these markers in the prognosis of patients with RCC, particularly that in those with...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11297.x
更新日期:2012-12-01 00:00:00
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journal_title:BJU international
pub_type: 传,历史文章,杂志文章
doi:10.1111/bju.12377
更新日期:2013-11-01 00:00:00