2012年USPSTF D级推荐反对前列腺特异性抗原筛查前后，根治性前列腺切除术与放射治疗对Gleason 5组前列腺癌的应用

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-02-05 DOI:10.1002/cam4.70624

H. Scott McGinnis, Taylor Corriher, James Janopaul-Naylor, Subir Goyal, Yuan Liu, Zelin Wang, Sagar A. Patel

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引用次数: 0

摘要

2012年美国预防服务工作组（USPSTF）推荐不进行前列腺特异性抗原（PSA）筛查的D级建议已导致在诊断时转向更高阶段的前列腺癌（PC）。我们评估了2012年前后美国格里森5级（GG5）前列腺癌根治性前列腺切除术（RP）与放射治疗（RT）的应用情况。研究人员从2004年至2017年的国家癌症数据库中筛选出34,011名局限性GG5 PC患者，他们接受了(1)RP或(2)RT +雄激素剥夺治疗（ADT）的主要治疗。采用卡方检验比较2012年前后RP和RT的相对使用情况。采用Cochran-Armitage趋势检验比较2004 - 2017年RP与RT的年度使用情况。我们使用多变量逻辑回归对治疗年份对RP使用的影响进行建模。结果在所有中心，RP的使用从31%增加到41% （p代表趋势<； 0.001）。2012年与所有中心RP使用增加的显著拐点相关。2012年后接受RP的几率增加（调整后OR为1.34,95% CI为1.28-1.40,p < 0.001）。结论：在过去的十年中，RP在GG5 PC中的应用在美国显著增加。目前尚不清楚这组高危男性的预后是否会受到影响，他们中的许多人在前列腺切除术后需要RT和/或ADT。需要前瞻性比较RP与RT + ADT治疗GG5型PC，以确定这些患者的最佳治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Utilization of Radical Prostatectomy Versus Radiation Therapy for Gleason Grade Group 5 Prostate Cancer Before and After USPSTF Grade D Recommendation Against Prostate-Specific Antigen Screening in 2012

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Objectives

The 2012 United States Preventive Services Task Force (USPSTF) Grade D recommendation against prostate-specific antigen (PSA) screening has resulted in a shift to higher-stage prostate cancer (PC) at diagnosis. We evaluate the utilization of radical prostatectomy (RP) versus radiation therapy (RT) in the US for Gleason grade group 5 (GG5) prostate cancer before and after 2012.

Methods

We identified 34,011 men with localized GG5 PC undergoing primary therapy with (1) RP or (2) RT + androgen deprivation therapy (ADT) between 2004 and 2017 from the National Cancer Database. The chi-square test was used to compare the relative use of RP and RT before versus after 2012. Annual use of RP versus RT from 2004 to 2017 was compared using Cochran-Armitage test for trend. We modeled the effect of treatment year on the use of RP using multivariable logistic regression.

Results

Across all centers, the use of RP increased from 31% to 41% (p for trend < 0.001). 2012 was associated with significant inflection for increase in RP use in all centers. There was an increased odds of receiving RP after 2012 (adjusted OR 1.34, 95% CI 1.28–1.40, p < 0.001).

Conclusions

Utilization of RP for GG5 PC has significantly increased in the United States over the past decade. It remains unknown if outcomes may be compromised in this group of high-risk men, many of whom require post-prostatectomy RT and/or ADT. Prospective comparison of RP versus RT + ADT for GG5 PC are needed to determine optimal treatment for these patients.

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.