Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis.

IF 2.1 4区医学 Q2 SURGERY

Journal of Investigative Surgery Pub Date : 2025-12-01 Epub Date: 2025-07-21 DOI:10.1080/08941939.2025.2534579

Xin Zhang, Sen Pan, Wei Sun, Chuanlin Wang

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引用次数: 0

Abstract

Background: In patients with newly diagnosed metastatic prostate cancer (mPCa), the appropriate population for radical prostatectomy (RP) remains unclear.

Patients and methods: Newly diagnosed mPCa patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into no local therapy (NLT) and RP groups. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier curves were used to estimate cancer-specific survival (CSS).

Results: A total of 9,215 patients were included, with 8,844 receiving NLT and 371 undergoing RP. After PSM, 321 patients in each group were included. RP was associated with significantly better CSS (HR = 0.38, 95% CI, 0.27-0.54, p < 0.001). Subgroup analyses showed consistent survival benefit of RP except in patients with M1c disease (HR = 0.55, 95% CI, 0.21-1.46, p = 0.229) or PSA ≥60 ng/ml (HR = 1.19, 95% CI, 0.53-2.86, p = 0.673). An exploratory classification defined low tumor burden as PSA <60 ng/ml and M1a/M1b disease, and high tumor burden as PSA ≥60 ng/ml or M1c. RP significantly improved CSS in the low tumor burden group (HR = 0.30, 95% CI, 0.20-0.46, p < 0.001), but not in the high tumor burden group (HR = 0.98, 95% CI, 0.53-1.84, p = 0.961).

Conclusion: In patients with newly diagnosed mPCa, the survival benefit of RP varies with tumor burden.

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新诊断的转移性前列腺癌根治性前列腺切除术的生存获益因PSA水平和转移部位而异。

背景：在新诊断的转移性前列腺癌（mPCa）患者中，根治性前列腺切除术（RP）的合适人群尚不清楚。患者和方法：从监测、流行病学和最终结果（SEER）数据库中确定新诊断的mPCa患者，并将其分为无局部治疗（NLT）组和RP组。倾向评分匹配（PSM）用于平衡基线特征。Kaplan-Meier曲线用于估计癌症特异性生存（CSS）。结果：共纳入9215例患者，其中8844例接受NLT， 371例接受RP。经PSM后，每组共纳入321例患者。RP与较好的CSS显著相关（HR = 0.38, 95% CI, 0.27-0.54, p < 0.001）。亚组分析显示，除了患有M1c疾病（HR = 0.55, 95% CI, 0.21-1.46, p = 0.229）或PSA≥60 ng/ml （HR = 1.19, 95% CI, 0.53-2.86, p = 0.673）的患者外，RP的生存获益一致。探索性分类将低肿瘤负荷定义为PSA （p = 0.961）。结论：在新诊断的mPCa患者中，RP的生存获益随肿瘤负荷而变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Investigative Surgery 医学-外科

CiteScore

4.20

自引率

0.00%

发文量

114

审稿时长

6-12 weeks

期刊介绍： Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.