Cancer - Prostate(구연)
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(E-127)
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전향적 코호트를 이용한 한국인 전립선암에서 적극적인 감시를 위한 엄격한 기준 적용의 임상영향 평가 |
1. 입원의학센터, 서울대학교병원
2. 비뇨의학과, 서울대학교병원
3. 비뇨의학과, 삼성의료원
4. 비뇨의학과, 고려대학교안산병원
5. 비뇨의학교실, 서울대학교 의과대학 |
서준교1,2, 육형동2, 강민용3, 태범식4, 구자현2,5, 김현회2,5, 곽철 2,5, 정창욱 2,5 |
Purpose: To evaluate the clinical impact of strict selection criteria for active surveillance (AS) of prostate cancer in a Korean population
Materials and Methods: A single-center, prospectively collected AS cohort from December 2016 to February 2019 (NCT02971085) was used. Following pre-determined criteria, patients were categorized into “strict AS” and “non-strict AS” groups. Clinicopathological progression-free survival (PFS) and treatment-free survival (TFS) of the two groups were compared using the Kaplan–Meier curve and log-rank test. Age-adjusted hazard ratios for clinicopathological progression was calculated using Cox proportional regression analysis.
Results: Of 54 eligible patients, 25 and 29 were assigned to “strict AS” and “non-strict AS,” respectively. The mean age was 66.9±5.2 and 65.5±7.8 years; PSA level was 4.8±1.7 and 6.0±2.2 ng/ml for “strict AS” and “non-strict AS” groups, respectively. Clinicopathological progression and definitive treatment rates were 28.0% (7/25 patients) vs. 58.6% (17/29 patients) and 32.0% (8/25 patients) vs. 62.1% (18/29 patients) in “strict AS” and “non-strict AS” groups. Surgical pathology in the patients who underwent radical prostatectomy was not statistically different between the groups. PFS (mean 34.6±2.9 vs. 22.6±2.7 months, p-value=0.025) and TFS (mean 31.8±3.2 vs. 19.6±2.4 months, p-value=0.018) favor the “strict AS” group than “non-strict AS” group. Age-adjusted hazard ratio for clinicopathological progression of strict criteria was 0.36 (95% confidence interval: 0.14–0.94, p-value=0.04).
Conclusion: PF and TFS were better in the “strict AS” group than in the “non-strict AS” group. This finding should be informed to relevant patients during decision making and considered in Korean guidelines.
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keywords : Prostate cancer , Active surveillance, Patient selection |
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