Izvorni znanstveni članak
Deferred treatment in prostate cancer: a median 3-year follow-up of 48 patients in Karlovac General Hospital
Davorin Katušin
; Department of Urology, Karlovac General Hospital, Karlovac, Croatia
Miljenko Križ
; Department of Urology, Karlovac General Hospital, Karlovac, Croatia
Željko Poka
; Department of Urology, Karlovac General Hospital, Karlovac, Croatia
Jasminka Sušanj
; Department of Urology, Karlovac General Hospital, Karlovac, Croatia
Doroteja Janković
; Department of Urology, Karlovac General Hospital, Karlovac, Croatia
Sažetak
The increasing number of localized, low-risk prostate cancers (PCa) detected on the basis of widespread prostate specific antigen (PSA) testing and PCa screening, as well as cognition that many of these tumors will not progress or will progress very slowly, face the urologists with dilemma to treat an early PCa immediately or to postpone active tumor-specific treatment until the signs of tumor progression. The concept of deferred treatment in terms of active surveillance (AS) or watchful waiting (WW) has become one of the most intriguing issues in urologic oncology. Despite many investigations, there is still no definitive conclusion about reliability and possible risk of deferred treatment for the patients with PCa. In our study we analyzed the outcome of 48 patients with low-risk PCa on deferred treatment (24 on AS and 24 on WW). Median age of the patients in the study was 74 years (56-85) with median PSA 7.7 ng/mL (0.4-29.0). The Gleason score was ≤6 in 97.5% patients with 75% of the patients with one positive core on biopsy or with less than 5% tumor in biopsy material after transurethral or transvesical prostatectomy. During a median follow-up of 36.5 months (2-196), in 12 (25.0%) patients a progression of the tumor was assessed. Median time to progression was 36 months (7-110) with probability to stay treatment- free after 5 years of 72.1%. In conclusion, the results of our study support the attitude that deferred treatment, in well selected patients with low-risk disease, can offer a safe option in treatment of PCa patients saving some of them from unnecessary procedures with a possible negative impact on the quality of life.
Ključne riječi
prostate cancer; deferred treatment; active surveillance; watchful waiting
Hrčak ID:
278639
URI
Datum izdavanja:
21.10.2010.
Posjeta: 330 *