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Zhou Z, Yue F, Jin L, Liu X, Zhai TS, Zhang JX, Gu WY, Liu SH, Luo M, Peng B, Yao XD, Ye L. Characteristics and risk differences of different tumor size on localized prostate cancer: A retrospective cohort study in the SEER database. Cancer Med 2021; 10:2763-2773. [PMID: 33724697 PMCID: PMC8026935 DOI: 10.1002/cam4.3856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/27/2022] Open
Abstract
Objective We aimed to evaluate the role of tumor size in predicting tumor risk for localized prostate cancer (PCa) patients undergoing radical prostatectomy (RP). Methods Twenty‐five thousand, one hundred twenty‐seven men with PCa receiving RP from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results database. Kaplan–Meier plots and multivariable Cox regression analyses were used to illustrate overall survival (OS) according to the tumor size. The tumor size was confirmed by postoperative pathology after RP. Results Among overall localized PCa, 84.6% were high‐risk PCa, 9.2% were intermediate‐risk PCa, and 6.2% were low‐risk PCa. Multivariate analyses demonstrated that tumor size ≥21 mm was an independent risk predict factor of low‐risk PCa (odds ratio [OR]: 11.940; 95% CI, 9.404–15.161; p < 0.001) and intermediate‐risk PCa (OR: 1.887; 95% CI, 1.586–2.245; p < 0.001). Tumor sizes ≤5 mm significantly correlated with high‐risk PCa (p < 0.001). Tumor size ≤5 mm had the worst OS in overall localized PCa and high‐risk PCa (p < 0.001). Conclusions In localized PCa, tumor sizes ≥21 mm may help predict low or intermediate‐risk PCa, while tumor sizes ≤5 mm might help predict high‐risk PCa. In clinical practice, we should be on high alert for patients with tumors size ≤5 mm due to its poor prognosis after RP.
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Affiliation(s)
- Zhen Zhou
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China.,Department of Urology,First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Feng Yue
- Department of Urology, Dalian Friendship Hospital, Dalian, Liaoning, China.,Department of Urology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Liang Jin
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Xiang Liu
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Ting-Shuai Zhai
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Jia-Xin Zhang
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Wen-Yu Gu
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Sheng-Hua Liu
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Ming Luo
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Bo Peng
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Xu-Dong Yao
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
| | - Lin Ye
- Department of Urology, Shanghai Tenth People's Hospital,Tongji University School of Medicine, Shanghai, China
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Lam TBL, MacLennan S, Willemse PPM, Mason MD, Plass K, Shepherd R, Baanders R, Bangma CH, Bjartell A, Bossi A, Briers E, Briganti A, Buddingh KT, Catto JWF, Colecchia M, Cox BW, Cumberbatch MG, Davies J, Davis NF, De Santis M, Dell'Oglio P, Deschamps A, Donaldson JF, Egawa S, Fankhauser CD, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Gross T, Grummet JP, Henry AM, Ingels A, Irani J, Lardas M, Liew M, Lin DW, Moris L, Omar MI, Pang KH, Paterson CC, Renard-Penna R, Ribal MJ, Roobol MJ, Rouprêt M, Rouvière O, Sancho Pardo G, Richenberg J, Schoots IG, Sedelaar JPM, Stricker P, Tilki D, Vahr Lauridsen S, van den Bergh RCN, Van den Broeck T, van der Kwast TH, van der Poel HG, van Leenders GJLH, Varma M, Violette PD, Wallis CJD, Wiegel T, Wilkinson K, Zattoni F, N'Dow JMO, Van Poppel H, Cornford P, Mottet N. EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study). Eur Urol 2019; 76:790-813. [PMID: 31587989 DOI: 10.1016/j.eururo.2019.09.020] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/11/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. OBJECTIVE To develop consensus statements for all domains of DAT. DESIGN, SETTING, AND PARTICIPANTS A protocol-driven, three phase study was undertaken by the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Association of Urology Section of Urological Research (ESUR)-International Society of Geriatric Oncology (SIOG) Prostate Cancer Guideline Panel in conjunction with partner organisations, including the following: (1) a systematic review to describe heterogeneity across all domains; (2) a two-round Delphi survey involving a large, international panel of stakeholders, including healthcare practitioners (HCPs) and patients; and (3) a consensus group meeting attended by stakeholder group representatives. Robust methods regarding what constituted the consensus were strictly followed. RESULTS AND LIMITATIONS A total of 109 HCPs and 16 patients completed both survey rounds. Of 129 statements in the survey, consensus was achieved in 66 (51%); the rest of the statements were discussed and voted on in the consensus meeting by 32 HCPs and three patients, where consensus was achieved in additional 27 statements (43%). Overall, 93 statements (72%) achieved consensus in the project. Some uncertainties remained regarding clinically important thresholds for disease extent on biopsy in low-risk disease, and the role of multiparametric magnetic resonance imaging in determining disease stage and aggressiveness as a criterion for inclusion and exclusion. CONCLUSIONS Consensus statements and the findings are expected to guide and inform routine clinical practice and research, until higher levels of evidence emerge through prospective comparative studies and clinical trials. PATIENT SUMMARY We undertook a project aimed at standardising the elements of practice in active surveillance programmes for early localised prostate cancer because currently there is great variation and uncertainty regarding how best to conduct them. The project involved large numbers of healthcare practitioners and patients using a survey and face-to-face meeting, in order to achieve agreement (ie, consensus) regarding best practice, which will provide guidance to clinicians and researchers.
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Affiliation(s)
- Thomas B L Lam
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK.
| | | | | | - Malcolm D Mason
- Division of Cancer and Genetics, School of Medicine Cardiff University, Velindre Cancer Centre, Cardiff, UK
| | - Karin Plass
- EAU Guidelines Office, Arnhem, The Netherlands
| | | | | | - Chris H Bangma
- Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital Malmö, Lund University, Lund, Sweden
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | | | - Alberto Briganti
- Department of Urology, Scientific Institute and University Vita-Salute San Raffaele Hospital, Milan, Italy
| | | | - James W F Catto
- Academic Urology Unit, University of Sheffield, Sheffield, UK; Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Maurizio Colecchia
- Uropathology Unit, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Brett W Cox
- Department of Radiation Medicine, Zucker School of Medicine, Hempstead, New York, NY, USA
| | | | | | - Niall F Davis
- Department of Urology, Beaumont and Connolly Hospitals, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maria De Santis
- Department of Urology, Charité University Hospital, Berlin, Germany
| | - Paolo Dell'Oglio
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; ORSI Academy, Melle, Belgium
| | | | - James F Donaldson
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Shin Egawa
- Asian School of Urology, UAA, Jikei University School of Medicine, Tokyo, Japan
| | | | - Stefano Fanti
- Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Italy
| | - Nicola Fossati
- Department of Urology, Scientific Institute and University Vita-Salute San Raffaele Hospital, Milan, Italy
| | - Giorgio Gandaglia
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Silke Gillessen
- Division of Cancer Sciences, University of Manchester and The Christie, Manchester, UK; Department of Medical Oncology and Haematology, Cantonal Hospital St. Gallen, University of Bern, Bern, Switzerland
| | - Nikolaos Grivas
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tobias Gross
- Department of Urology, University of Bern, Bern, Switzerland
| | - Jeremy P Grummet
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
| | - Ann M Henry
- Leeds Cancer Centre, St. James's University Hospital, Leeds, UK
| | | | - Jacques Irani
- University Hospital of Bicêtre-Paris Sud-Saclay University, Le Kremlin Bicêtre, France
| | - Michael Lardas
- Department of Reconstructive Urology and Surgical Andrology, Metropolitan General, Athens, Greece
| | - Matthew Liew
- Department of Urology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Daniel W Lin
- Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Urology, University of Washington, Seattle, WA, USA
| | - Lisa Moris
- Department of Urology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Molecular Endocrinology, KU Leuven, Leuven, Belgium
| | | | - Karl H Pang
- Academic Urology Unit, University of Sheffield, Sheffield, UK
| | - Catherine C Paterson
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; University of Canberra, School of Nursing, Midwifery and Public Health, Canberra, Australia; Robert Gordon University, School of Nursing and Midwifery, Aberdeen, UK
| | - Raphaële Renard-Penna
- Academic Department of Radiology, Sorbonne Université, GRC no 5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière-Hôpital Tenon, Paris, France
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Morgan Rouprêt
- Urology Department, Sorbonne Université, GRC no 5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Rouvière
- Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France; Université de Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
| | - Gemma Sancho Pardo
- Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jonathan Richenberg
- Royal Sussex County Hospital Brighton and Brighton and Sussex Medical School, Brighton, Sussex, UK
| | - Ivo G Schoots
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J P Michiel Sedelaar
- Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Phillip Stricker
- Department of Urology, St Vincents Hospital and Campus, Sydney, Australia; Garvan Institute of Research, Sydney, Australia
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Vahr Lauridsen
- Department of Urology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | - Henk G van der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Murali Varma
- Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Philippe D Violette
- Departments of Health Research Methods, Evidence and Impact (HEI) and Surgery, McMaster University, Hamilton, ON, Canada
| | - Christopher J D Wallis
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thomas Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | | | - Fabio Zattoni
- Urology Unit, Academic Medical Centre Hospital, Udine, Italy
| | - James M O N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | | | - Philip Cornford
- Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
| | - Nicolas Mottet
- Department of Urology, University Hospital Jean Monnet, St. Etienne, France
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