Watchful waiting or watchful progression

摘要: BACKGROUND Prostate specific antigen doubling time (PSAdt) is a dynamic model of prostate tumor biology. It predicts aggressive disease and subsequent clinical recurrence after radical treatment. However, as yet there only limited evidence for its validity in the watchful waiting population. METHODS One hundred thirteen previously untreated patients with adenocarcinoma who were referred to British Columbia Cancer Agency management opinion subsequently placed into prospective program. The reasons waiting, previous medical history, serial PSA, histopathologic data recorded. RESULTS The median age was 75 years (range, 49-85 years). follow-up from first appointment 14 months 0-58 months). correlated highly T classification (P = 0.003) past history 0.002). Approximately 40% T1 51% T2 had progression by 2 years, increasing 60% at 3 years. On multivariate analysis PSAdt strongly < 0.0001), stage 0.01), treatment 0.0001); grade initial not found be predictive any endpoints studied. Initial PSA significant predicting 0.03). 50% <18 progressed within 6 months. At last follow-up, no deaths carcinoma been recorded. Overall survival 5 92% 68%, respectively. CONCLUSIONS Using digital rectal examination, findings this study demonstrated high rates population. rather than standard criteria most powerful indicator activity. 1998;82:342-8. © 1998 American Society.