Characteristics of incidental prostate cancer in the United States

医学 前列腺癌 前列腺切除术 比例危险模型 置信区间 泌尿科 内科学 放射治疗 癌症 危险系数 前列腺 流行病学 肿瘤科
作者
Lukas Scheipner,Reha‐Baris Incesu,Simone Morra,Andrea Baudo,Anis Assad,Letizia Maria Ippolita Jannello,Carolin Siech,Mario de Angelis,Francesco Barletta,Zhe Tian,Fred Saad,Shahrokh F. Shariat,Alberto Briganti,Felix K.‐H. Chun,Derya Tilki,Nicola Longo,Luca Carmignani,Ottavio De Cobelli,Sascha Ahyai,Pierre I. Karakiewicz
出处
期刊:Prostate Cancer and Prostatic Diseases [Springer Nature]
卷期号:27 (4): 709-714 被引量:8
标识
DOI:10.1038/s41391-023-00742-7
摘要

Data regarding North-American incidental (cT1a/b) prostate cancer (PCa) patients is scarce. To address this, incidental PCa characteristics (age, PSA values at diagnosis, Gleason score [GS]), subsequent treatment and cancer-specific survival (CSS) rates were explored.Incidental PCa patients were identified within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015). Descriptive statistics, annual percentage changes (EAPC), Kaplan-Meier estimates, as well as Cox regression models were used. Bootstrapping technique was used to generate 95% confidence intervals for CSS at 6 years.Of all 344,031 newly diagnosed non metastatic PCa patients, 5155 harbored incidental PCa. Annual rates of incidental PCa increased from 1.9% (2004) to 2.5 % (2015; p = 0.02). PSA values at diagnosis were 0-4 ng/ml in 48% vs. 4-10 ng/ml in 31% vs. > 10 ng/ml in 21%. Of all incidental PCa patients, 64% harbored GS 6 vs. 25% GS 7 vs. 11% GS ≥ 8. Of all incidental PCa patients, 47% were aged < 70, 35% were between 70 and 79 and 18% were ≥ 80 years. Subsequently, 71% underwent no local treatment (NLT) vs. 16% radical prostatectomy (RP) vs. 14% radiotherapy (RT). Proportions of patients with NLT increased from 65 to 81% (p = 0.0001) over the study period (2004-2015). CSS at six years ranged from 58% in GS ≥ 8 patients with NLT to 100% in patients who harbored GS 6 and underwent either RP or RT.Incidental PCa in the United States is rare. Most incidental PCa patients are diagnosed in men aged less than 80 years of age. The majority of incidental PCa patients undergo NLT and enjoy excellent CSS.
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