在前列腺特异性抗原筛查时代管理局限性前列腺癌。
Managing localized prostate cancer in the era of prostate-specific antigen screening.
机构信息
Department of Urology, Stanford University, Stanford, California.
出版信息
Cancer. 2013 Nov 15;119(22):3906-9. doi: 10.1002/cncr.28301. Epub 2013 Sep 4.
Abstract
Because prostate cancer is diagnosed by blind biopsy, there is underlying uncertainty as to its extent and aggressiveness, evidenced by 40% of cases being upgraded after surgery compared to the diagnostic biopsy. This uncertainty contributes to the overtreatment of low risk localized prostate cancer that fuels the current debate surrounding prostate cancer screening and treatment. This issue presents presents a validated tool that uses clinical variables to predict upgrading of Gleason score 6 prostate cancer. Ideally, this and other tools should increase the acceptance, safety and use of active surveillance in men with localized prostate cancer detected by screening and help to address the problem of overtreatment.
摘要
由于前列腺癌是通过盲目活检诊断的，因此其范围和侵袭性存在潜在的不确定性，有 40%的病例在手术后比诊断性活检升级。这种不确定性导致了对低风险局限性前列腺癌的过度治疗，这也是当前围绕前列腺癌筛查和治疗的争论焦点。本研究提出了一种使用临床变量预测 Gleason 评分 6 前列腺癌升级的验证工具。理想情况下，这种工具和其他工具应该提高通过筛查检测到局限性前列腺癌的男性对主动监测的接受度、安全性和使用，并有助于解决过度治疗的问题。
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