On the growth rates of human malignant tumors : Implications for medical decision making.
Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days.
Cancers from the breast, prostate, and colon are frequently slow-growing, displaying a TVDT of months or years.
Irrespective of their growth rates, most human tumors have been found : to start from one single cell, to have a long subclinical period, to grow at constant rates for long periods of time, to start to metastasize often even before the primary is detected, and to have metastases that often grow at approximately the same rate as the primary tumor.
The recognition of basic facts in tumor cell kinetics is essential in the evaluation of important present-day strategies in oncology.
Among the facts emphasized in this review are : (1) Screening programs.
Most tumors are several years old when detectable by present-day diagnostic methods.
This makes the term clearly detection questionable. (2) Legal trials.
The importance of so-called doctor's delay is often discussed, but the prognostic value of « early »detection is overestimated. (3) Analyses of clinical trials.
Such analysis may be differentiated depending on the growth rates of the type of tumor studied.
Furthermore, uncritical analysis of survival data may be misleading if the TVDT is not taken into consideration. (4) Analyses of epidemiological data. (...)
Mots-clés Pascal : Tumeur maligne, Taux croissance, Epidémiologie, Critère décision, Temps doublement, Diagnostic, Facteur risque, Qualité vie, Article synthèse, Homme, Cancérologie, Politique sanitaire
Mots-clés Pascal anglais : Malignant tumor, Growth rate, Epidemiology, Decision criterion, Doubling time, Diagnosis, Risk factor, Quality of life, Review, Human, Cancerology, Health policy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0461164
Code Inist : 002B04B. Création : 03/02/1998.