Thomsen Frederik B, Mikkelsen Marta K, Hansen Rikke B, Krug Andrea H, Glenthøj Anders, Stattin Pär, Brasso Klaus
a Department of Urology , Bispebjerg and Frederiksberg Hospital , Frederiksberg , Denmark.
b Copenhagen Prostate Cancer Center, Department of Urology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.
Acta Oncol. 2016 Dec;55(12):1456-1460. doi: 10.1080/0284186X.2016.1191667. Epub 2016 Jun 22.
The Danish Cancer Registry holds information on all prostate cancers (PCa) cases, including diagnostic TNM. However, stratification according to contemporary risk classification is not possible because histopathological grading and prostate-specific antigen (PSA) level are not registered. The objective of the study was to report clinical characteristics and primary management of men diagnosed with PCa from a primary referral center in Denmark.
Records on all men diagnosed with PCa at the Department of Urology, Frederiksberg Hospital, 1 January 2007 - 31 December 2013, were reviewed. Clinical characteristics and primary treatment were recorded. The National Comprehensive Cancer Network risk group classification was used.
A total of 1934 men with a median age of 69 years (interquartile range 65-75) were diagnosed with PCa in the study period resulting in an incidence rate (World Standard Population) of 84/100 000. Overall, 18% were classified as low-risk, 34% as intermediate-risk, 23% as high-risk, 8% as very high-risk and 17% had metastatic disease at diagnosis. Among men age <65 years 70% had low- or intermediate-risk disease, while this was the case for 58% of men aged 65-75 and 22% of men aged >75. Metastatic disease was found in 11% of men <65 years, 17% of men 65-75 years and 23% of men >75 years. In total 73% of men with low-risk PCa were managed on watchful waiting or active surveillance. Curatively intended treatment was performed in 56% of men with intermediate-risk and 61% of men with high-risk PCa, while hormonal therapy was used in 90% of men with very high-risk and 98% of men with metastatic PCa.
In a population without systematic PSA testing we found a large proportion of patients presenting with advanced PCa at diagnosis. Elderly patients presented with more advanced disease. Curative treatment was primarily used in younger men with clinically localized PCa.
丹麦癌症登记处保存了所有前列腺癌（PCa）病例的信息，包括诊断性TNM分期。然而，由于未记录组织病理学分级和前列腺特异性抗原（PSA）水平，因此无法根据当代风险分类进行分层。本研究的目的是报告丹麦一家初级转诊中心诊断为PCa的男性的临床特征和初始治疗情况。
回顾了2007年1月1日至2013年12月31日在腓特烈斯贝格医院泌尿外科诊断为PCa的所有男性的记录。记录临床特征和初始治疗情况。采用美国国立综合癌症网络风险组分类。
在研究期间，共有1934名中位年龄为69岁（四分位间距65 - 75岁）的男性被诊断为PCa，发病率（世界标准人口）为84/10万。总体而言，18%被归类为低风险，34%为中风险，23%为高风险，8%为极高风险，17%在诊断时已有转移性疾病。年龄<65岁的男性中，70%患有低风险或中风险疾病，而65 - 75岁男性中这一比例为58%，>75岁男性中为22%。<65岁男性中11%发现有转移性疾病，65 - 75岁男性中为17%，>75岁男性中为23%。低风险PCa患者中，共有73%接受观察等待或主动监测。中风险PCa患者中有56%、高风险PCa患者中有61%接受了根治性治疗，而极高风险PCa患者中有90%、转移性PCa患者中有98%接受了激素治疗。
在一个没有系统PSA检测的人群中，我们发现很大一部分患者在诊断时患有晚期PCa。老年患者的疾病更为晚期。根治性治疗主要用于临床局限性PCa的年轻男性。
