Portal de Periódicos da CAPES

PROGNOSTIC FEATURES IN MEN WHO DIED OF PROSTATE CANCER

2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 2 Linguagem: Inglês

10.1097/01.ju.0000165184.72337.9d

1527-3792

Kadee E Thompson, Javier Hernández, Edith Canby‐Hagino, Dean A. Troyer, Ian M. Thompson,

Urologic and reproductive health conditions

No AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 Aug 2005PROGNOSTIC FEATURES IN MEN WHO DIED OF PROSTATE CANCER KADEE E. THOMPSON, JAVIER HERNÁNDEZ, EDITH D. CANBY-HAGINO, DEAN TROYER, and IAN M. THOMPSON KADEE E. THOMPSONKADEE E. THOMPSON , JAVIER HERNÁNDEZJAVIER HERNÁNDEZ , EDITH D. CANBY-HAGINOEDITH D. CANBY-HAGINO , DEAN TROYERDEAN TROYER , and IAN M. THOMPSONIAN M. THOMPSON View All Author Informationhttps://doi.org/10.1097/01.ju.0000165184.72337.9dAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Since the advent of widespread prostate specific antigen (PSA) based screening in the United States, the risk of over diagnosis as well as delayed diagnosis due to existing PSA thresholds has become a concern. Treatment decision planning is generally linked to prognostic variables, most notably PSA, clinical stage and Gleason grade. We examined these and other prognostic variables in a cohort of men who ultimately died of prostate cancer. Materials and Methods: Of 413 men with prostate cancer in a cohort in San Antonio, Texas between 1993 and 2003 who died of disease we identified 211 who died as a direct result of prostate cancer. In these cases we assessed presenting symptoms, PSA history, tumor stage and Gleason score at diagnosis. Results: Of the 211 men 141 (67%) underwent screening for prostate cancer prior to diagnosis. Of 190 men with PSA data at diagnosis available 7 (3.7%) had PSA less than 4.0 ng/ml and 27 (14%) had PSA 4.0 to 10.0 ng/ml. Clinical stage distribution was cT1 in 21.1% of cases, cT2 in 50.7% and cT3 in 26.8%. Of 167 men for whom biopsy Gleason grade was available 16.8%, 16.2%, 24% and 43.1% had Gleason sum 5 or less, 6, 7 and 8 or higher, respectively. Conclusions: While most men who ultimately die of prostate cancer have poor prognostic features, a substantial number have features associated with a potentially good prognosis, including low PSA and low Gleason grade. Many men who died of prostate cancer had undergone prior screening. These data demonstrate the need for improved markers of prognosis and continued assessment of the efficacy of screening with PSA. References 1 : Cancer mortality surveillance—United States, 1990–2000. MMWR Surveill Summ2004; 53: 1. Google Scholar 2 : Cancer statistics, 2005. CA Cancer J Clin2005; 55: 10. Google Scholar 3 : A catalog of prostate cancer nomograms. J Urol2001; 165: 1562. Link, Google Scholar 4 : Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med2004; 350: 2239. Google Scholar 5 : Cancer progression and survival rates following anatomical radical retropubic prostatectomy in 3,478 consecutive patients: long-term results. J Urol2004; 172: 910. Link, Google Scholar 6 : Trends in prostate cancer mortality among black men and white men in the United States. Cancer2003; 97: 1507. Google Scholar 7 : The science of early detection. Urol Oncol2004; 22: 344. Google Scholar 8 : Presentation and clinical course of patients ultimately succumbing to carcinoma of the prostate. Scand J Urol Nephrol1991; 25: 111. Google Scholar 9 : National Institutes of Health Consensus Development Conference Statement: adjuvant therapy for breast cancer, November 1–3, 2000. J Natl Cancer Inst2001; 93: 979. Google Scholar 10 : Combination conformal radiotherapy and radioimmunoguided transperineal 103Pd implantation for patients with intermediate and unfavorable risk prostate adenocarcinoma. Brachytherapy2003; 2: 215. Google Scholar 11 : Impact of hormone therapy when combined with external beam radiotherapy for early-stage, intermediate-, or high-risk prostate cancer. Am J Clin Oncol2003; 26: 382. 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Link, Google Scholar Departments of Urology and Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLavery H and Droller M (2018) Do Gleason Patterns 3 and 4 Prostate Cancer Represent Separate Disease States?Journal of Urology, VOL. 188, NO. 5, (1667-1675), Online publication date: 1-Nov-2012.Thompson I and Lucia M (2018) Diagnosing Prostate Cancer: Through a Glass, DarklyJournal of Urology, VOL. 175, NO. 5, (1598-1599), Online publication date: 1-May-2006.Thompson I (2018) Defining High Risk Prostate Cancer—Where do we Set the Bar? A Translational Science Approach to Risk StratificationJournal of Urology, VOL. 176, NO. 6S, (S21-S24), Online publication date: 1-Dec-2006. Volume 174Issue 2August 2005Page: 553-556 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsmass screeningprostatic neoplasmsprostate-specific antigenmortalityprostateMetricsAuthor Information KADEE E. THOMPSON More articles by this author JAVIER HERNÁNDEZ More articles by this author EDITH D. CANBY-HAGINO More articles by this author DEAN TROYER More articles by this author IAN M. THOMPSON More articles by this author Expand All Advertisement PDF downloadLoading ...