Abstract
Background
Debate regarding a nomenclature change for grade group 1 (GG 1) prostate cancer to noncancer has been revived, as this could be a powerful tool in reducing the overtreatment of indolent disease.
Objective
To describe outcomes for all men diagnosed with GG 1 prostate cancer in the Danish population, with a focus on men followed conservatively.
Design, setting, and participants
This was a population-based observational study using data from the Danish Prostate Registry.
Outcome measurements and statistical analysis
We measured the cumulative incidence of curative treatment, endocrine treatment, and cause-specific mortality.
Results and limitations
The cumulative incidence of endocrine therapy at 10 yr was 5.3% (95% confidence interval [CI] 4.3–6.3%) for men with initial active surveillance and 21% (95% CI 19–23%) for men with initial watchful waiting for localized GG 1. In the GG1 cohort, the prostate cancer–specific mortality rate at 15 yr was 14% (95 CI% 11–16%) for men on watchful waiting, 10% (95 CI% 6.7–14%) for men with prostate-specific antigen <10 ng/ml on watchful waiting, and 16% (95 CI% 13–19%) for men who did not receive curative-intent treatment or histological assessment. The study is limited by the historic nature of the observations over a period during which diagnostic procedures and treatments have evolved.
Conclusions
GG 1 cancer can lead to disease-specific mortality in men with localized prostate cancer, and changing the nomenclature for all men may lead to undertreatment.
Debate regarding a nomenclature change for grade group 1 (GG 1) prostate cancer to noncancer has been revived, as this could be a powerful tool in reducing the overtreatment of indolent disease.
Objective
To describe outcomes for all men diagnosed with GG 1 prostate cancer in the Danish population, with a focus on men followed conservatively.
Design, setting, and participants
This was a population-based observational study using data from the Danish Prostate Registry.
Outcome measurements and statistical analysis
We measured the cumulative incidence of curative treatment, endocrine treatment, and cause-specific mortality.
Results and limitations
The cumulative incidence of endocrine therapy at 10 yr was 5.3% (95% confidence interval [CI] 4.3–6.3%) for men with initial active surveillance and 21% (95% CI 19–23%) for men with initial watchful waiting for localized GG 1. In the GG1 cohort, the prostate cancer–specific mortality rate at 15 yr was 14% (95 CI% 11–16%) for men on watchful waiting, 10% (95 CI% 6.7–14%) for men with prostate-specific antigen <10 ng/ml on watchful waiting, and 16% (95 CI% 13–19%) for men who did not receive curative-intent treatment or histological assessment. The study is limited by the historic nature of the observations over a period during which diagnostic procedures and treatments have evolved.
Conclusions
GG 1 cancer can lead to disease-specific mortality in men with localized prostate cancer, and changing the nomenclature for all men may lead to undertreatment.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | European urology oncology |
| Vol/bind | 7 |
| Udgave nummer | 4 |
| Sider (fra-til) | 770-777 |
| Antal sider | 8 |
| DOI | |
| Status | Udgivet - 2024 |