A Critical Analysis of the Tumor Volume Threshold for Clinically Insignificant Prostate Cancer Using a Data Set of a Randomized Screening Trial

Wolters, Tineke; Roobol, Monique J.; Leeuwen, Pim J. van; Bergh, Roderick C.N. van den; Hoedemaeker, Robert F.; Leenders, Geert J.L.H. van; Schröder, Fritz H.; Kwast, Theodorus H. van der

doi:10.1016/j.juro.2010.08.082

Cited by 242 publications

(214 citation statements)

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“…Among the most prominent population-based cohorts representative of patients from the USA and Europe are the Surveillance, Epidemiology, and End Results (SEER) registry, the linked SEER-Medicare database, and clinical registries in Sweden, Norway, and Japan [25,26,[28][29][30][31][32]. Established as part of the National Cancer Act in 1971, the SEER registry provides national cancer statistics that support efforts to reduce the burden of cancer among the US population [4,33].…”

Section: 3mentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate cancer, outcomes, statistical approaches, population-based cohorts, registries of outcomes, and epidemiological studies, alone or in combination. We limited our search to studies published between January 2005 and January 2015. Evidence synthesis: Several population-based and prospective disease-specific registries are currently available for prostate cancer. Studies performed using these data sources provide important information on incidence and mortality, disease characteristics at presentation, risk factors, trends in utilization of health care services, disparities in access to treatment, quality of care, long-term oncologic and health-related quality of life outcomes, and costs associated with management of the disease. Although data from these registries have some limitations, statistical methods are available that can address certain biases and increase the internal and external validity of such analyses. In the future, improvements in data quality, collection of tissue samples, and the availability of data feedback to health care providers will increase the relevance of studies built on population-based and disease-specific registries. Conclusions: The strengths and limitations of PCa registries should be carefully considered when planning studies using these databases. Although randomized controlled trials still provide the highest level of evidence, large registries play an important and growing role in advancing PCa research and care. Patient summary: Several population-based and prospective disease-specific registries for prostate cancer are currently available. Analyses of data from these registries yield information that is clinically relevant for the management of patients with prostate cancer.

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Section: 3mentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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“…In another cystoprostatectomy series of 97 specimens, in men in the UK where PSA screening rates are low, the same methodology found a threshold of 1.09 mls, illustrating the arbitrary nature of this volume cut-off [20]. Recent work in screen-detected cancer supports the suitability of the 0.5 mL threshold value for any tumour stage or grade, but for Gleason 3+3, organconfined disease this value could be as high as 1.3 mL for the index lesion and 2.5 mL for the total tumour volume [21].…”

Section: Clinically Significant Cancermentioning

confidence: 93%

When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

Stavrinides

Parker

Moore

2017

Cancer Treatment Reviews

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Title:When no treatment is the best treatment: active surveillance strategies for low risk prostate cancers. Abstract:Although the incidence of prostate cancer is rising due to PSA screening and increased life expectancy, the metastatic potential of low-grade, organ-confined disease remainslow. An increasing number of studies suggest that radical treatment in such cases confers little or no survival benefit at a significant cost to morbidity. Active surveillance is a promising management approach of such low-risk cancers: eligible patients are selected based on clinical and pathological findings at diagnosis and are regularly monitored with digital rectal examinations, PSA testing and biopsies. Treatment, however, is deferred until and unless there is evidence of disease progression. This is a key difference from watchful waiting, where treatment is avoided until and unless there are symptoms. The purpose of this work is to review the rationale and evidence behind active surveillance and to offer an overview of current active surveillance strategies and outcomes.

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“…There is much evidence that this is an overly stringent definition. Recently, the ERSPC group performed a similar analysis based on the ERSPC patients [13]. Their conclusion was that the threshold for clinically insignificant disease was a cancer volume < 1.3 cc.…”

Section: Definition Of Clinically Insignificant Prostate Cancermentioning

confidence: 99%

Active Surveillance for Low-Risk Prostate Cancer

Klotz

2015

Curr Urol Rep

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A Critical Analysis of the Tumor Volume Threshold for Clinically Insignificant Prostate Cancer Using a Data Set of a Randomized Screening Trial

Cited by 242 publications

References 20 publications

Prostate Cancer Registries: Current Status and Future Directions

Prostate Cancer Registries: Current Status and Future Directions

When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

Active Surveillance for Low-Risk Prostate Cancer

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