PD62-04 LONG-TERM ONCOLOGICAL OUTCOMES FOLLOWING ACTIVE SURVEILLANCE OF LOW RISK PROSTATE CANCER: A POPULATION-BASED STUDY
Notice bibliographique
Résumé
You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD62)1 Apr 2020PD62-04 LONG-TERM ONCOLOGICAL OUTCOMES FOLLOWING ACTIVE SURVEILLANCE OF LOW RISK PROSTATE CANCER: A POPULATION-BASED STUDY Narhari Timilshina*, Antonio Finelli, Patrick Richard, Maria Komisarenko, Lisa Martin, George Tomlinson, Beate Sander, and Shabbir Alibhai Narhari Timilshina*Narhari Timilshina* More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Patrick RichardPatrick Richard More articles by this author , Maria KomisarenkoMaria Komisarenko More articles by this author , Lisa MartinLisa Martin More articles by this author , George TomlinsonGeorge Tomlinson More articles by this author , Beate SanderBeate Sander More articles by this author , and Shabbir AlibhaiShabbir Alibhai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000979.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) is a widely accepted management strategy for low-risk prostate cancer (PC), but limited data exist regarding long-term outcomes after initial AS at a population level. We assessed the long-term outcomes of low-risk PC following initial AS at a population level. METHODS: In this population-based study using linked administrative databases from Ontario, Canada, we identified PC patients with low-risk (Gleason score ≤6) cancer who were initially managed with AS between 2002-2014. Our primary outcomes of metastases (mets) rate, overall mortality (OM) and prostate cancer-specific mortality (PCSM) were compared between AS patients and low-risk patients who received initial definitive treatment (either surgery or radiation) using Cox proportional hazards models. RESULTS: The cohort was comprised of 31,004 (11,259 Initial AS, 6,819 Watchful Waiting (WW) and 12,926 Initial Treatment) low-risk PC patients (median age, 65 years) with median follow-up of 107 months (IQR 76-140). AS patients had lower PSA (median 5.9, no IQR), had lower positive cores (mean 2, SD 1.6) and lower maximum % core (median 10, IQR 5-15) than WW or Initial treatment. Mets rate was lower in AS (3.9%) than initial treatment (6.6%) or WW (5.5%). Unadjusted OM was lower among those with initial AS (7.7%) than with initial treatment (9.4%) or WW (25.1%), with median follow-up of 9 years. Factors associated with OM were WW, age, higher ACG comorbidity, higher PSA, number of positive cores and max. % core at diagnosis, lower income and geographical region. In adjusted multivariate model for OM, AS was not statistically different than initial treatment (HR 1.03, 95%CI 0.93-1.14). Unadjusted PCSM was higher among patients undergoing WW (1.44%) versus initial AS (0.73%) or when compared to initial treatment (0.60%). CONCLUSIONS: The study reports real-world long-term outcomes of AS in men with low-risk PC. Our results suggest that AS is not associated with worse OM but slightly higher PCSM with AS than upfront treatment after 9 years of follow-up. Source of Funding: The Prostate Cancer Canada © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1286-e1287 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Narhari Timilshina* More articles by this author Antonio Finelli More articles by this author Patrick Richard More articles by this author Maria Komisarenko More articles by this author Lisa Martin More articles by this author George Tomlinson More articles by this author Beate Sander More articles by this author Shabbir Alibhai More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».