Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Int J Urol. 2014 Apr;21(4):377-81. doi: 10.1111/iju.12326. Epub 2013 Oct 29.
To investigate the ability of six contemporary active surveillance protocols to appropriately select active surveillance candidates among Korean men who underwent radical prostatectomy.
Between January 2001 and December 2011, 1968 patients underwent radical prostatectomy for prostate cancer at Samsung Medical Center, Seoul, Korea. Patients met the criteria for active surveillance according to six currently used criteria, including those from the Johns Hopkins Hospital, the University of Toronto, the University of California at San Francisco, the Prospective Prostate Cancer Research International Active Surveillance, the University of Miami and the Memorial Sloan-Kettering Cancer Center. The rates of Gleason score upgrading, upstaging and misclassification at final pathology were assessed.
Among 1006 assessable patients, the percentage of men eligible for active surveillance varied from 13.5% to 38.5%, depending on the criteria used. The rates of upgrading ranged from 41.6% to 50.6%. Extracapsular extension was reported in 4.1% to 8.5% of patients, whereas seminal vesicle invasion was reported in 0.5% to 1.6% of patients. The upstaging rates according to the six active surveillance criteria varied from 4.5% to 9.3%, and the rates of misclassification varied from 44.5% to 54.8%.
Currently available active surveillance criteria might not be suitable in Korean patients with prostate cancer, as they have a high likelihood of underestimating cancer.
探讨 6 种当代主动监测方案在选择韩国接受根治性前列腺切除术的男性主动监测候选者方面的能力。
2001 年 1 月至 2011 年 12 月期间，韩国首尔三星医疗中心有 1968 名患者因前列腺癌接受根治性前列腺切除术。患者符合根据 6 种当前使用的标准进行主动监测的标准，包括约翰霍普金斯医院、多伦多大学、旧金山加利福尼亚大学、前列腺癌前瞻性研究国际主动监测、迈阿密大学和纪念斯隆-凯特琳癌症中心的标准。评估最终病理的 Gleason 评分升级、升级和分类错误率。
在 1006 例可评估患者中，根据所使用的标准，符合主动监测条件的男性比例从 13.5%到 38.5%不等。升级率从 41.6%到 50.6%不等。包膜外延伸率在 4.1%至 8.5%的患者中报告，而精囊侵犯率在 0.5%至 1.6%的患者中报告。根据 6 种主动监测标准的升级率从 4.5%到 9.3%不等，分类错误率从 44.5%到 54.8%不等。
目前可用的主动监测标准可能不适用于韩国前列腺癌患者，因为它们很可能低估癌症。
