NDLI: Intérêt de la densité du PSA comme facteur prédictif chez les patients afro-caribéens éligibles à la surveillance active du cancer de prostate selon les critères du protocole français.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Loiselle, A. Senechal, C. Nevoux, P. Benazzouz, H. Bhakkan-Mambir, B. Casenave, J. Gourtaud, G. Fofana, M. Blanchet, P.
Spatial Coverage	Caribbean Region France
Description	Author Affiliation: Loiselle A ( CHU de Brest, boulevard Tanguy-Prigent, 29200 Brest, France. Electronic address: Aurelien.Loiselle@etudiant.univ-brest.fr.); Senechal C ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.); Nevoux P ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.); Benazzouz H ( CHU de Rabat, Rabat, Maroc.); Bhakkan-Mambir B ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.); Casenave J ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.); Gourtaud G ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.); Fofana M ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.); Blanchet P ( CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre, Guadeloupe.)
Abstract	OBJECTIVES: Study the interest of addition of PSA density (PSAD), to the selection criteria of the French protocol for inclusion patients Afro-Caribbean on active surveillance prostate cancer. METHODS: A retrospective analysis of 1505 patients who had, in turn, a radical prostatectomy for cancer between 2000 and 2012, in a single reference center. One hundred and forty-one patients was eligible, at the time of their diagnosis, for active surveillance by the criteria of the French protocol. This population was divided into 2 groups according to the histological analysis of the prostatectomy specimen confirmed indolent cancer or overturned. The median PSAD of each group was calculated to be compared. Secondarily, the most discriminating PSAD was investigated by the method of ROC after constitution tables intrinsic validity in this population. This threshold has secondary conducting a comparative analysis of the underestimation of cancer in terms of aggressiveness and/or extension between patients selected according to the criteria of the French protocol and 'on-selected' patients according to these criteria and their PSAD. RESULTS: Of the 141 patients identified for analysis, histological examination of the prostatectomy specimen has to show that 42 patients (29.7 %) were actually more aggressive cancer (20.6 % of Gleason ≥ 7), wider (4.2 % ≥ pT3) or larger and more aggressive (4.9 %) than foreshadowed criteria French protocol. The median PSAD these 42 patients were significantly higher than the median PSAD patients correctly estimated (0.18 vs. 0.14, p-value=0.046). The application of the most discriminating threshold: 0.15 ng/ml/cm(3) in this population allowed to significantly improve the selection of candidates of the 79 'on-selected' patients, six (20.2 %) were actually more aggressive cancer (13.9 % of Gleason ≥ 7), wider (2.5 % ≥ pT3) or larger and more aggressive (3.8 %). CONCLUSION: The criteria for the French protocol for active surveillance, applied to the Caribbean population underestimate 29 % of non-latent cancers. Adjuvants criteria that must be inexpensive, sensitive and specific seem necessary in this population. A PSAD<0.15 ng/ml/cm(3) could be one of these criteria.
File Format	HTM / HTML
ISSN	11667087
Issue Number	6
Volume Number	24
Journal	Progr`es en Urologie
Language	French
Publisher	Elsevier
Publisher Date	2014-05-01
Publisher Place	France
Access Restriction	Subscribed
Subject Keyword	Humans Middle Aged Clinical Protocols Male Predictive Value Of Tests Blood Journal Article Prostatic Neoplasms Neoplasm Grading Surgery Retrospective Studies Diagnosis France Tumor Markers, Biological Discipline Urology Sensitivity And Specificity Neoplasm Invasiveness Risk Factors Ethnology Caribbean Region Prostate-specific Antigen English Abstract Pathology Follow-up Studies Prostatectomy Aged Population Surveillance Methods
Alternative Title	The significance of PSA density as predictive factor in Afro-Caribbean patients eligible for active surveillance by the French protocol criteria
Content Type	Text
Resource Type	Article
Subject	Urology

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