Is Low-Risk Prostate Cancer More Indolent in Younger Patients ?
Menée auprès de 1 433 patients atteints d'un cancer de la prostate et bénéficiant d'une surveillance active (âge médian au diagnostic : 63 ans ; durée médiane de suivi : 49 mois), cette étude évalue l'association entre l'âge des patients au diagnostic et la progression du score de Gleason à la biopsie durant la surveillance active, ainsi que le risque de traitement définitif ou de récidive biochimique après une prostatectomie radicale différée
The paradox of prostate cancer has been thoroughly debated in the medical literature over the past several decades. Although prostate cancer is the most incident visceral tumor of men living in the Western hemisphere; it is fatal in a relatively small fraction of those in whom it is detected. Improving patient selection for radical therapy through a personalized approach on the basis of tumor and patient characteristics has been the charge of several contemporary expert panels. In 2011, a National Institutes of Health panel endorsed active surveillance as a standard option for low-risk prostate cancer. The National Comprehensive Cancer Network offers active surveillance as a primary option for low- and very low-risk prostate cancer and it is the preferred option for men with shorter life expectancies. The National Institutes of Health and National Comprehensive Cancer Network have each called for more research in this evolving treatment area with the goals of developing evidence-based decision tools and the identification of biomarkers indicative of early-grade progression in patients on active surveillance.
Journal of Clinical Oncology , éditorial en libre accès, 2016