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Population-based outcomes of men with a single negative prostate biopsy: Importance of continued follow-up among older patients.
Sayyid, Rashid K; Alibhai, Shabbir M H; Sutradhar, Rinku; Eberg, Maria; Fung, Kinwah; Klaassen, Zachary; Goldberg, Hanan; Perlis, Nathan; Madi, Rabii; Terris, Martha K; Urbach, David R; Fleshner, Neil E.
Afiliação
  • Sayyid RK; Department of Surgical Oncology, University Health Network, Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada; Division of Surgery, Section of Urology, Augusta University, Augusta, GA. Electronic address: rksayyid@gmail.com.
  • Alibhai SMH; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada; Department of Medicine, University Health Network, Toronto, ON, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
  • Sutradhar R; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Eberg M; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
  • Fung K; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
  • Klaassen Z; Department of Surgical Oncology, University Health Network, Toronto, ON, Canada; Division of Surgery, Section of Urology, Augusta University, Augusta, GA; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
  • Goldberg H; Department of Surgical Oncology, University Health Network, Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
  • Perlis N; Department of Surgical Oncology, University Health Network, Toronto, ON, Canada.
  • Madi R; Division of Surgery, Section of Urology, Augusta University, Augusta, GA.
  • Terris MK; Division of Surgery, Section of Urology, Augusta University, Augusta, GA.
  • Urbach DR; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Department of Surgery, Women's College Hospital, Toronto, ON, Canada.
  • Fleshner NE; Department of Surgical Oncology, University Health Network, Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
Urol Oncol ; 37(5): 298.e19-298.e27, 2019 05.
Article em En | MEDLINE | ID: mdl-30770299
ABSTRACT

PURPOSE:

To determine in Ontario-based men with a single negative transrectal ultrasound-guided prostate biopsy the long-term rates of prostate cancer-specific mortality, diagnosis, and treatment; number of repeat biopsies; and predictors of prostate cancer diagnosis and mortality. MATERIALS AND

METHODS:

This was a population-based cohort study, using data from linked, validated health administrative databases, of all Ontario-based men with a negative first biopsy between January 1994 and October 2014. Patients were followed from time of first biopsy till death, administrative censoring, or end of study period. Cumulative incidence functions were used to calculate the study outcomes' cumulative incidences. Univariable and multivariable regression analyses using Fine and Gray's semiparametric proportional hazards model were used to assess predictors of prostate cancer diagnosis and mortality.

RESULTS:

The study cohort included 95,675 men with a median age of 63.0years. Median follow-up was 8.1years. The 20-year cumulative rates of prostate cancer-specific mortality and diagnosis were 1.8% and 23.7%, respectively. Men ages 70 to 79 and 80 to 84 at initial biopsy had 20-year prostate cancer-specific mortality cumulative rates of 3.2% and 6.4% respectively. The 20-year cumulative rate of receiving radical prostatectomy was 7.6%. Higher socioeconomic status and urban residence were associated with higher diagnosis risks yet lower prostate cancer-specific mortality risks.

CONCLUSIONS:

This is the first population-based study assessing long-term cancer outcomes in North American men with a single negative transrectal ultrasound-guided prostate biopsy. Following a negative initial biopsy, 23.7% of men are still diagnosed with and 1.8% die of prostate cancer within 20years. Cancer-specific mortality outcomes are significantly worse in older men, with prostate cancer mortality rates several times higher than the rest of the population.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Próstata / Neoplasias da Próstata Idioma: En Ano de publicação: 2019 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Próstata / Neoplasias da Próstata Idioma: En Ano de publicação: 2019 Tipo de documento: Article