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Comparison of pathological outcomes of active surveillance candidates who underwent radical prostatectomy using contemporary protocols at a high-volume Korean center

Authors
 Dong Hoon Lee  ;  Ha Bum Jung  ;  Seung Hwan Lee  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Sung Jun Hong  ;  Seung Choul Yang  ;  Byung Ha Chung 
Citation
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY, Vol.42(11) : 1079-1085, 2012 
Journal Title
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY 
ISSN
 0368-2811 
Issue Date
2012
MeSH
Aged ; Cohort Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/standards ; Pathology, Clinical/methods* ; Pathology, Clinical/standards ; Population Surveillance/methods* ; Practice Guidelines as Topic/standards ; Prognosis ; Prostatectomy/methods* ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery* ; Reproducibility of Results ; Republic of Korea
Keywords
prostate cancer ; active surveillance ; Korean
Abstract
OBJECTIVE: We compared contemporary active surveillance protocols based on pathological outcomes in patients who underwent radical prostatectomy. METHODS: We identified the experimental cohort from prostate cancer patients who underwent radical prostatectomy between 2001 and 2011 ; and who met the inclusion criteria of five published active surveillance protocols ; namely Johns Hopkins Medical Institution ; University of California at San Francisco ; Memorial Sloan-Kettering Cancer Center ; University of Miami and Prostate Cancer Research International: Active Surveillance. To compare each protocol ; we evaluated the pathological outcomes and calculated the sensitivity ; specificity and accuracy for each protocol according to the proportion of organ-confined Gleason≤6 disease. RESULTS: Overall ; 376 patients met the inclusion criteria of the active surveillance protocols with 61 ; 325 ; 222 ; 212 and 206 patients meeting the criteria of the Johns Hopkins Medical Institution ; University of California at San Francisco ; Memorial Sloan-Kettering Cancer Center ; University of Miami and Prostate Cancer Research International: Active Surveillance protocols ; respectively. The sensitivity and specificity values of the five protocols ; respectively ; were 0.199 and 0.882 in Johns Hopkins Medical Institution ; 0.855 and 0.124 in University of California at San Francisco ; 0.638 and 0.468 in Memorial Sloan-Kettering Cancer Center ; 0.599 and 0.479 in University of Miami ; and 0.609 and 0.527 in Prostate Cancer Research International: Active Surveillance. In terms of both the sensitivity and specificity ; Prostate Cancer Research International: Active Surveillance was the most balanced protocol. In addition ; Prostate Cancer Research International: Active Surveillance showed a more accurate performance for favourable pathological outcomes than the others. However ; using the area under the curve to compare the discriminative ability of each protocol ; there were no statistically significant differences. CONCLUSIONS: The contemporary active surveillance protocols showed similar pathological characteristics in patients who had undergone radical prostatectomy. However ; we concluded that the Prostate Cancer Research International: Active Surveillance protocol would be most helpful to Korean populations in choosing candidates for active surveillance considering the balance between sensitivity and specificity and the accuracy of diagnosis.
Files in This Item:
T201205359.pdf Download
DOI
22988037
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yang, Seung Choul(양승철)
Lee, Dong Hoon(이동훈)
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Jung, Ha Bum(정하범)
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90594
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