Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study
Objective: To examine associations between objective signs of progression (triggers) and transition from active surveillance (AS) to radical treatment for prostate cancer (PC). Patients and methods: This case-control study included men with low- or favourable intermediate-risk PC in the region of H...
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| Format: | Article |
| Language: | English |
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Medical journals sweden AB
2024-03-01
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| Series: | Scandinavian Journal of Urology |
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| Online Access: | https://medicaljournalssweden.se/SJU/article/view/34803 |
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| author | Mats Ahlberg Hans Garmo Pär Stattin Rolf Gedeborg Christer Edlund Lars Holmberg Anna Bill-Axelson |
| author_facet | Mats Ahlberg Hans Garmo Pär Stattin Rolf Gedeborg Christer Edlund Lars Holmberg Anna Bill-Axelson |
| author_sort | Mats Ahlberg |
| collection | DOAJ |
| description | Objective: To examine associations between objective signs of progression (triggers) and transition from active surveillance (AS) to radical treatment for prostate cancer (PC).
Patients and methods: This case-control study included men with low- or favourable intermediate-risk PC in the region of Halland, with data from The National Prostate Cancer Register (NPCR), Sweden, starting AS between 2008 and 2020. Cases were men who transitioned to radical treatment. For each case, 10 controls who remained in AS were selected without further matching. Triggers for transition to treatment were histopathological progression, magnetic resonance imaging (MRI) progression and increases in prostate-specific antigen (PSA) levels. We compared the probabilities for triggers between cases and controls, in 2008–2014 and 2015–2020, using logistic regression.
Results: Amongst 846 men, we identified 98 cases in 2008–2014 and 172 cases in 2015–2020. Histopathological progression was associated with transition, most strongly in the later period (2008–2014: odds ratios [OR] 6.88, 95% confidence interval [CI] 3.69–12.80; and 2015–2020: OR 75.29, 95% CI 39.60–143.17). MRI progression was associated with transition in 2015–2020 (OR 6.38, 95% CI 2.70–15.06), whereas an increase in PSA was weakly associated with transition in the early period. The absence of triggers was associated with no transition (2008–2014: OR 0.24, 95% CI 0.15–0.40, and 2015–2020: OR 0.09, 95% CI 0.06–0.14). The probability of no trigger was 27% in cases 2015–2020.
Conclusion: The increase in association between histopathological trigger and transition to treatment indicates increased quality of AS. Still, amongst men treated from 2015 to 2020, 27% transitioned without any trigger.
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| format | Article |
| id | doaj-art-dabaa37eb8a04c22a2e02f889aebef2f |
| institution | OA Journals |
| issn | 2168-1813 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Medical journals sweden AB |
| record_format | Article |
| series | Scandinavian Journal of Urology |
| spelling | doaj-art-dabaa37eb8a04c22a2e02f889aebef2f2025-08-20T02:29:23ZengMedical journals sweden ABScandinavian Journal of Urology2168-18132024-03-015910.2340/sju.v59.34803Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control studyMats Ahlberg0Hans Garmo1Pär Stattin2Rolf Gedeborg3Christer Edlund4Lars Holmberg5Anna Bill-Axelson6Department of Surgical Sciences, Uppsala University, Uppsala, SwedenDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden; Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, UKDepartment of Surgical Sciences, Uppsala University, Uppsala, SwedenDepartment of Surgical Sciences, Uppsala University, Uppsala, SwedenUrologkliniken, Hallands sjukhus, Kungsbacka, SwedenTranslational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, UK; Department of Surgical Sciences, Uppsala University, Uppsala, SwedenDepartment of Surgical Sciences, Uppsala University, Uppsala, SwedenObjective: To examine associations between objective signs of progression (triggers) and transition from active surveillance (AS) to radical treatment for prostate cancer (PC). Patients and methods: This case-control study included men with low- or favourable intermediate-risk PC in the region of Halland, with data from The National Prostate Cancer Register (NPCR), Sweden, starting AS between 2008 and 2020. Cases were men who transitioned to radical treatment. For each case, 10 controls who remained in AS were selected without further matching. Triggers for transition to treatment were histopathological progression, magnetic resonance imaging (MRI) progression and increases in prostate-specific antigen (PSA) levels. We compared the probabilities for triggers between cases and controls, in 2008–2014 and 2015–2020, using logistic regression. Results: Amongst 846 men, we identified 98 cases in 2008–2014 and 172 cases in 2015–2020. Histopathological progression was associated with transition, most strongly in the later period (2008–2014: odds ratios [OR] 6.88, 95% confidence interval [CI] 3.69–12.80; and 2015–2020: OR 75.29, 95% CI 39.60–143.17). MRI progression was associated with transition in 2015–2020 (OR 6.38, 95% CI 2.70–15.06), whereas an increase in PSA was weakly associated with transition in the early period. The absence of triggers was associated with no transition (2008–2014: OR 0.24, 95% CI 0.15–0.40, and 2015–2020: OR 0.09, 95% CI 0.06–0.14). The probability of no trigger was 27% in cases 2015–2020. Conclusion: The increase in association between histopathological trigger and transition to treatment indicates increased quality of AS. Still, amongst men treated from 2015 to 2020, 27% transitioned without any trigger. https://medicaljournalssweden.se/SJU/article/view/34803active surveillanceprostate cancertriggers for transition to radical treatment |
| spellingShingle | Mats Ahlberg Hans Garmo Pär Stattin Rolf Gedeborg Christer Edlund Lars Holmberg Anna Bill-Axelson Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study Scandinavian Journal of Urology active surveillance prostate cancer triggers for transition to radical treatment |
| title | Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study |
| title_full | Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study |
| title_fullStr | Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study |
| title_full_unstemmed | Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study |
| title_short | Triggers for transition from active surveillance to radical treatment of prostate cancer 2008–2020 – a case-control study |
| title_sort | triggers for transition from active surveillance to radical treatment of prostate cancer 2008 2020 a case control study |
| topic | active surveillance prostate cancer triggers for transition to radical treatment |
| url | https://medicaljournalssweden.se/SJU/article/view/34803 |
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