Posttreatment surveillance intensity and overall survival in prostate cancer survivors (AFT-30).

IF 3.4 Q2 ONCOLOGY
Ronald C Chen, Ramsankar Basak, Stacie Dusetzina, Deborah S Usinger, Zahed Mohammed, Aaron D Falchook, Jessica R Schumacher, Amanda B Francescatti, Amanda Cuddy, George J Chang, Benjamin D Kozower, Caprice C Greenberg, Anne K Barber, Aaron J Katz
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引用次数: 0

Abstract

Background: Posttreatment surveillance affects millions of cancer survivors, but empiric data to guide clinical practice are lacking. This study assessed whether the intensity of surveillance testing after radical prostatectomy or radiation therapy for localized prostate cancer is associated with overall survival.

Methods: Men diagnosed with localized prostate cancer between 2005 and 2010 who underwent radical prostatectomy or radiation therapy at a Commission on Cancer-accredited facility were randomly sampled. Primary data collected from 10 147 patients sampled across 1007 facilities were linked with existing data from the National Cancer Database. Analysis examined whether intensity of surveillance measured as the number of prostate-specific antigen (PSA) tests in the first year after primary treatment (categorized as 0-1 [low intensity], 2 [medium], or ≥3 [high intensity] PSA tests) was associated with overall survival. Secondary outcomes included recurrence-free survival (RFS) and subsequent use of imaging tests, biopsy procedures, and salvage treatment.

Results: Median follow-up exceeded 8 years from prostate cancer diagnosis. Overall survival was not statistically significantly different across surveillance intensity groups among radiation therapy (P = .59) or radical prostatectomy (P = .29) patients. RFS was not statistically significantly different across surveillance intensity groups for radiation therapy (P = .13) patients but was for radical prostatectomy (P = .01) patients with high intensity associated with the worst RFS. In both treatments, higher surveillance intensity was associated with more procedures and salvage treatments.

Conclusions: In patients with localized prostate cancer, more frequent PSA surveillance testing after radical prostatectomy or radiation therapy was associated with increased procedures and salvage treatments but not overall survival.

前列腺癌幸存者的治疗后监测强度和总生存率(AFT-30)。
背景:治疗后监测影响着数百万癌症幸存者,但缺乏经验数据来指导临床实践。本研究评估了局部前列腺癌根治性前列腺切除术(RP)或放射治疗(RT)后监测检测的强度是否与总生存率有关:方法:随机抽样 2005 年至 2010 年期间确诊为局部前列腺癌并在癌症委员会认可的医疗机构接受前列腺癌根治术或放疗的男性患者。从 1007 家医疗机构的 10147 名患者中收集的原始数据与国家癌症数据库中的现有数据进行了关联。分析检验了以初级治疗后第一年的 PSA 检测次数(分为 0-1 次(低强度)、2 次(中强度)或≥ 3 次(高强度)PSA 检测)来衡量的监测强度是否与总生存率相关。次要结果包括无复发生存率(RFS)以及随后使用的成像检测、活检程序和挽救治疗:结果:自前列腺癌确诊起,中位随访时间超过 8 年。RT(P = .59)或RP(P = .29)患者的OS在不同监测强度组间无明显统计学差异。RT(P = .13)患者的 RFS 在不同监控强度组间无明显统计学差异,但 RP(P = .01)患者的 RFS 与高监控强度相关,RFS 较差。在两种治疗方法中,较高的监控强度与较多的手术和挽救治疗有关:结论:在局部前列腺癌患者中,根治性前列腺切除术或放射治疗后更频繁地进行 PSA 监测与手术和挽救治疗的增加有关,但与总生存率无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JNCI Cancer Spectrum
JNCI Cancer Spectrum Medicine-Oncology
CiteScore
7.70
自引率
0.00%
发文量
80
审稿时长
18 weeks
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