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Master Thesis

La surveillance active du cancer de prostate en Guadeloupe, une cohorte prospective de 234 cas inclus selon les critères de l’université de Toronto

Abstract : Introduction : Active surveillance (AS) is a treatment option for prostate cancer (PCa) of favorable risk. Yet datas on populations from sub-Saharan Africa are lacking. The objective of this study was to evaluate the safety and benefit of AS in a Caribbean population of men with favorable risk PCa. Patients and methods : A mono-center prospective cohort study was conducted in Guadeloupe including patients with a favorable risk PCa in AS. Treatment was recommended in case of: histological progression, biopsy volume progression or PSA doubling time <36 months. The endpoints were overall survival, cancer-specific survival and time to stopping AS. Multivariate analysis was performed using the Cox model to search for predictive factors at baseline for stopping AS. Results : A total of 234 men (median age, 64 years) were included. Median follow-up was 4 years. Overall survival at 2.5 years, 5 years and 10 years was respectively 99.5%, 98.5%, 90.7%. Specific survival at 2.5 years, 5 years and 10 years was 100%. At 2.5 years, 5 years and 10 years, 72.7%, 52.6%, 40.4% of patients remained untreated and on AS. PSA density (p <0.001; HR = 1.52 by additional 0.1; 95% CI = 1.20 to 1.89) was found as an independent prective factors for stopping AS. Conclusion : AS is safe and beneficial for Caribbeans patients with favorable risk PCa. The rate of patients who have stopped AS seem to reflect a greater proportion of aggressive cancers in this population. PSA density might help to have a better selection of these patients.
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Master Thesis
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Matthias Meunier. La surveillance active du cancer de prostate en Guadeloupe, une cohorte prospective de 234 cas inclus selon les critères de l’université de Toronto. Urologie et Néphrologie. 2016. ⟨dumas-01686828⟩

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