Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?

Background In 2002, we reported the initial results of a trial comparing radical prostatectomy with watchful waiting in the management of early prostate cancer. After three more years of follow-up, we report estimated 10-year results. Methods: From October 1989 through February 1999, 695 men with ea...

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Autores principales:	Rivera M,Solange, Catalano N,Hugo, Manzotti E,Matías, Valenzuela DB,Lorena, Nine M,Cecilia
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2006
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000100018
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spelling	oai:scielo:S0034-988720060001000182006-03-08Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?Rivera M,SolangeCatalano N,HugoManzotti E,MatíasValenzuela DB,LorenaNine M,CeciliaBackground In 2002, we reported the initial results of a trial comparing radical prostatectomy with watchful waiting in the management of early prostate cancer. After three more years of follow-up, we report estimated 10-year results. Methods: From October 1989 through February 1999, 695 men with early prostate cancer (mean age, 64.7 years) were randomly assigned to radical prostatectomy (347 men) or watchful waiting (348 men). The follow-up was complete through 2003, with blinded evaluation of the causes of death. The primary end point was death due to prostate cancer; thesecondary end points were death from any cause, metastasis, and local progression. Results: During a median of 8.2 years of follow-up, 83 men in the surgery group and 106 men in the watchful-waiting group died (P=0.04). In 30 of the 347 men assigned to surgery (8.6 percent) and 50 of the 348 men assigned to watchful waiting (14.4 percent), death was due to prostate cancer. The difference in the cumulative incidence of death due to prostate cancer increased from 2.0 percentage points after 5 years to 5.3 percentage points after 10 years, for a relative risk of 0.56 (95 percent confidence interval, 0.36 to 0.88; P=0.01 by Gray's test). For distant metastasis, the corresponding increase was from 1.7 to 10.2 percentage points, for a relative risk in the surgery group of 0.60 (95 percent confidence interval, 0.42 to 0.86; P=0.004 by Gray's test), and for local progression, the increase was from 19.1 to 25.1 percentage points, for a relative risk of 0.33 (95 percent confidence interval, 0.25 to 0.44; P<0.001 by Gray's test). Conclusions: Radical prostatectomy reduces disease-specific mortality, overall mortality, and the risks of metastasis and local progression. The absolute reduction in the risk of death after 10 years is small, but the reductions in the risks of metastasis and local tumor progression are substantialinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.134 n.1 20062006-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000100018es10.4067/S0034-98872006000100018
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
description	Background In 2002, we reported the initial results of a trial comparing radical prostatectomy with watchful waiting in the management of early prostate cancer. After three more years of follow-up, we report estimated 10-year results. Methods: From October 1989 through February 1999, 695 men with early prostate cancer (mean age, 64.7 years) were randomly assigned to radical prostatectomy (347 men) or watchful waiting (348 men). The follow-up was complete through 2003, with blinded evaluation of the causes of death. The primary end point was death due to prostate cancer; thesecondary end points were death from any cause, metastasis, and local progression. Results: During a median of 8.2 years of follow-up, 83 men in the surgery group and 106 men in the watchful-waiting group died (P=0.04). In 30 of the 347 men assigned to surgery (8.6 percent) and 50 of the 348 men assigned to watchful waiting (14.4 percent), death was due to prostate cancer. The difference in the cumulative incidence of death due to prostate cancer increased from 2.0 percentage points after 5 years to 5.3 percentage points after 10 years, for a relative risk of 0.56 (95 percent confidence interval, 0.36 to 0.88; P=0.01 by Gray's test). For distant metastasis, the corresponding increase was from 1.7 to 10.2 percentage points, for a relative risk in the surgery group of 0.60 (95 percent confidence interval, 0.42 to 0.86; P=0.004 by Gray's test), and for local progression, the increase was from 19.1 to 25.1 percentage points, for a relative risk of 0.33 (95 percent confidence interval, 0.25 to 0.44; P<0.001 by Gray's test). Conclusions: Radical prostatectomy reduces disease-specific mortality, overall mortality, and the risks of metastasis and local progression. The absolute reduction in the risk of death after 10 years is small, but the reductions in the risks of metastasis and local tumor progression are substantial
author	Rivera M,Solange Catalano N,Hugo Manzotti E,Matías Valenzuela DB,Lorena Nine M,Cecilia
spellingShingle	Rivera M,Solange Catalano N,Hugo Manzotti E,Matías Valenzuela DB,Lorena Nine M,Cecilia Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?
author_facet	Rivera M,Solange Catalano N,Hugo Manzotti E,Matías Valenzuela DB,Lorena Nine M,Cecilia
author_sort	Rivera M,Solange
title	Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?
title_short	Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?
title_full	Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?
title_fullStr	Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?
title_full_unstemmed	Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?
title_sort	análisis crítico de un artículo: cáncer de próstata inicial ¿operar o esperar?
publisher	Sociedad Médica de Santiago
publishDate	2006
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000100018
work_keys_str_mv	AT riveramsolange analisiscriticodeunarticulocancerdeprostatainicialoperaroesperar AT catalanonhugo analisiscriticodeunarticulocancerdeprostatainicialoperaroesperar AT manzottiematias analisiscriticodeunarticulocancerdeprostatainicialoperaroesperar AT valenzueladblorena analisiscriticodeunarticulocancerdeprostatainicialoperaroesperar AT ninemcecilia analisiscriticodeunarticulocancerdeprostatainicialoperaroesperar
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Análisis crítico de un artículo: Cáncer de próstata inicial ¿operar o esperar?

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