Using the Surveillance, Epidemiology and End Results Program, we evaluated the changing demographics of poorly differentiated prostate cancer since early detection measures, such as serum prostate specific antigen screening, were introduced into clinical practice in the United States.
Trends between 1973 and 1994 in the proportion, stage and treatment of poorly differentiated tumors (International Classification of Diseases [ICD]-O code 3, Gleason score 8,9,10) were assessed, and multivariate Cox proportional hazards models were used to identify independent correlates of disease specific survival.
The number of ICD-O grade 3 tumors increased during the study period, although these comprised a decreased proportion of all diagnosed cases (24.4% of 29,588 in 1980 to 1984 versus 21.4% of 81,932 in 1990 to 1994, chi-square p<0.001).
ICD-O grade 3 tumors were less often metastatic in 1990 to 1994 compared to 1980 to 1984 (17.4% versus 33.1%, chi-square p<0.0001) and more often treated with radical prostatectomy or radiotherapy in 1990 to 1994 compared to 1983 to 1984 (37.5 versus 15.6%, chi-square p<0.001).
Although treatment group (radiotherapy versus radical prostatectomy) among patients with clinically confined tumors was an independent correlate of disease specific survival (hazard ratio 2.3,1983 to 1984 and 3.3,1990 to 1994), one must recognize potential selection biases inherent to this nonrandomized tumor registry study. (...)
Mots-clés Pascal : Adénocarcinome, Prostate, Faible, Cytodifférenciation, Evolution, Epidémiologie, Métastase, Stade clinique, Réponse, Traitement, Etude statistique, Homme, Tumeur maligne, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie
Mots-clés Pascal anglais : Adenocarcinoma, Prostate, Low, Cell differentiation, Evolution, Epidemiology, Metastasis, Clinical stage, Response, Treatment, Statistical study, Human, Malignant tumor, Urinary system disease, Male genital diseases, Prostate disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0419839
Code Inist : 002B30A01A2. Création : 25/01/1999.