Abstract
Validated nomograms for predicting prostate cancer evolution and development have recently been introduced by Dong et al 1 Dong F. Kattan M.W. Steyerberg E.W. et al. Validation of pretreatment nomograms for predicting indolent prostate cancer: efficacy in contemporary urological practice. J Urol. 2008; 180: 150-154 Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar in daily clinical practice. In contrast, Stattin et al 2 Stattin P. Holmberg E. Johansson J.E. et al. Outcomes in localized prostate cancer: National Prostate Cancer Register of Sweden follow-up study. J Natl Cancer Inst. 2010; 102: 950-958 Crossref PubMed Scopus (193) Google Scholar demonstrated that prostate cancer-specific mortality was only 2.4% among men with low-risk prostate cancer, and Krakowsky et al 3 Krakowsky Y. Loblaw A. Klotz L. Prostate cancer death of men treated with initial active surveillance: clinical and biochemical characteristics. J Urol. 2010; 184: 131-135 Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar stated that only 1 of 5 patients presented with favorable disease and experienced a theoretically preventable death. Patients with prostate cancer diagnosed on the basis of a single focus <3 mm of moderately differentiated tumor (Gleason score ≤6) have a 30% chance of harboring an insignificant tumor in their prostate and are therefore at risk of overtreatment. 4 Boccon-Gibod L.M. Dumonceau O. Toublanc M. et al. Micro-focal prostate cancer: a comparison of biopsy and radical prostatectomy specimen features. Eur Urol. 2005; 48: 895-899 Abstract Full Text Full Text PDF PubMed Scopus (81) Google Scholar ProPSA and Diagnostic Biopsy Tissue DNA Content Combination Improves Accuracy to Predict Need for Prostate Cancer Treatment Among Men Enrolled in an Active Surveillance ProgramUrologyVol. 77Issue 3PreviewTo assess a novel application of the Prostate Health Index (phi) and biopsy tissue DNA content in benign-adjacent and cancer areas to predict which patients would eventually require treatment of prostate cancer in the Proactive Surveillance cohort. Full-Text PDF ReplyUrologyVol. 77Issue 3PreviewEstimates indicate that prostate cancer (PCa) overdiagnosis constitutes about 56%,1 resulting in significant over treatment and there is always a chance of a decreased quality of life once sexual function and urinary function are compromised.2,3 The criteria to identify “indolent” PCa for active surveillance (AS) are controversial and based upon retrospective analysis that involve routine pretreatment clinical and biopsy pathologic parameters, such as Gleason score >7.0, number of positive cores, amount of cancer per core, the total prostate-specific antigen (PSA) level (>10 ng/mL), and also PSA density (PSAD). Full-Text PDF
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