PSA Kinetics and Risk of Death From Prostate Cancer In Search of the Holy Grail of Surrogate End Points

摘要

The long natural history of localized prostate cancer makes it a particularly difficult disease in which to study the impact of any therapy.4 Most newly diagnosed patients with prostate cancer would live for many years without treatment,5 those that are treated often live more than a decade even if they are not cured by their therapy,6 and the majority of patients die of something other than prostate cancer whether or not they are treated.5'78 Since improved survival has traditionally been the criterion standard against which cancer treatments are measured, it may take 15 to 20 years from a study's inception to demonstrate a survival advantage, or lack thereof, in localized prostate cancer.9 Contrast this situation to that of glioblastoma or pancreatic cancer, diseases which, if left untreated, have survival time measured in weeks: with these cancers, death usually follows closely on the heels of a relapse, and few patients die of competing causes.