Comparison of clinical and survival characteristics between prostate cancer patients of PSA-based screening and clinical diagnosis in China
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Libo Xu1, Jinguo Wang2, Baofeng Guo3, Haixia Zhang4, Kaichen Wang3, Ding Wang1, Chang Dai5, Ling Zhang1 and Xuejian Zhao1
1Department of Pathophysiology, College of Basic Medical Science, Jilin University, Changchun, China
2Department of Urology, The First Hospital of Jilin University, Changchun, China
3Department of Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
4Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
5Department of Ophthalmology, Second Hospital of Jilin University, Changchun, China
Ling Zhang, email: [email protected]
keywords: prostate cancer, PSA-based mass screening, prostate-cancer specific mortality, overall survival, metastases
Received: May 19, 2017 Accepted: June 29, 2017 Published: September 08, 2017
Prostate-specific antigen (PSA)-based mass screening remains the most controversial topic in prostate cancer. PSA-based mass screening has not been widely used in China yet. The aim of our study was to evaluate the effect of the PSA-based screening in China. The cohort consisted of 1,012 prostate cancer patients. Data were retrospectively collected and clinical characteristics of the cohorts were investigated. Survival was analyzed for prostatic carcinoma of both PSA screened and clinically diagnosed patients according to clinical characteristics and the National Comprehensive Cancer Network (NCCN) risk classification. Cox Proportional Hazards Model analysis was done for risk predictor identification. The median age was 71 years old. Five-year overall and prostate-cancer-specific survival in prostatic adenocarcinoma patients were 77.52% and 79.65%; 10-year survivals were 62.57% and 68.60%, respectively. Survival was significantly poorer in patients with metastases and non-curative management. T staging and Gleason score by NCCN classification effectively stratified prostatic adenocarcinoma patients into different risk groups. T staging was a significant predictor of survival by COX Proportional Hazard Model. PSA screened patients had a significantly higher percentage diagnosed in early stage. PSA screened prostatic adenocarcinoma patients had a better prognosis in both overall and prostate cancer-specific survivals. This Chinese cohort had a lower overall and prostate cancer survival rate than it is reported in western countries. The incidence of early-stage prostate cancer found in PSA-based mass screening was high and there were significant differences in both overall and prostate cancer-specific survival between the PSA-screened and clinically diagnosed patients.
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