Evidence map›Paper›PMID 31496491›Full record

ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2019

A novel predictor of clinical progression in patients on active surveillance for prostate cancer.

Guan Hee Tan, Antonio Finelli, Ardalan Ahmad, Marian S Wettstein, Thenappan Chandrasekar, Alexandre R Zlotta, Neil E Fleshner, Robert J Hamilton, Girish S Kulkarni, Khaled Ajib and 2 more

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In one paragraph

Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Guan Hee TanDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Antonio FinelliDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Ardalan AhmadDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Marian S WettsteinDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Thenappan ChandrasekarDepartment of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States.
Alexandre R ZlottaDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Neil E FleshnerDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Robert J HamiltonDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Girish S KulkarniDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Khaled AjibDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Gregory NasonDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Nathan PerlisDivision of Urology, Princess Margaret Cancer Center and Toronto General Hospital, University Health Network, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionActive surveillance (AS) is standard of care in low-risk prostate cancer (PCa). This study describes a novel total cancer location (TCLo) density metric and aims to determine its performance in predicting clinical progression (CP) and grade progression (GP).

methodsThis was a retrospective study of patients on AS after confirmatory biopsy (CBx). We excluded patients with Gleason ≥7 at CBx and <2 years followup. TCLo was the number of locations with positive cores at diagnosis (DBx) and CBx. TCLo density was TCLo/prostate volume (PV). CP was progression to any active treatment while GP occurred if Gleason ≥7 was identified on repeat biopsy or surgical pathology. Independent predictors of time to CP or GP were estimated with Cox regression. Kaplan-Meier analysis compared progression-free survival (PFS) curves between TCLo density groups. Test characteristics of TCLo density were explored with receiver operating characteristic (ROC) curves.

resultsWe included 181 patients who had CBx from 2012-2015 and met inclusion criteria. The mean age of patients was 62.58 years (standard deviation [SD] 7.13) and median followup was 60.9 months (interquartile range [IQR] 23.4). A high TCLo density score (>0.05) was independently associated with time to CP (hazard ratio [HR] 4.70; 95% confidence interval [CI] 2.62-8.42; p<0.001) and GP (HR 3.85; 95% CI 1.91-7.73; p<0.001). ROC curves showed TCLo density has greater area under the curve than number of positive cores at CBx in predicting progression.

conclusionsTCLo density is able to stratify patients on AS for risk of CP and GP. With further validation, it could be added to the decision-making algorithm in AS for low-risk localized PCa.

Identifiers

PMID31496491
PMCPMC6737740

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.