一项多机构研究表明,高危前列腺癌患者术前风险分层可以预测根治性手术后个体患者生化复发的风险

IF 0.2 Q4 UROLOGY & NEPHROLOGY
C. Devlin, M. Raslan, A. Deytrikh, Shacheesh Sinha, Samuel Murgatroyd, D. Yates, M. Dooldeniya, Nicholas Smith, M. Simms, R. Beekharry, Rajindra Singh, C. Molokwu, R. Chahal
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引用次数: 0

摘要

本研究的目的是确定哪些高危前列腺癌症(HRPCa)患者在根治性前列腺切除术(RP)后会发生生化复发(BCR),在首次咨询时提供个性化的%风险。BCR更可能存在于HRPCa中;然而,这一群体的发病率并不相等。2013年至2019年间,四家机构共有850名患者接受了HRPCa RP治疗。RP后立即进行额外治疗是排除标准,剩下832名患者。患者人口统计学、术前、组织学特征和BCR(PSA)的发生率 ⩾ 0.2 ng/mL)。患者是根据一个、两个或三个高危因素进行风险分层的患者。分类变量采用卡方检验。进行单变量分析,并采用Kaplan–Meier方法探讨各组间无BCR生存率。中位随访时间为48 月。BCR的总发生率为19.8%。BCR的中位时间为19 月。在风险分层分析中,75%的患者有一个风险特征。多种风险特征具有显著更高的手术切缘阳性风险和BCR发生率(p < 0.001),但不是BCR的时间(p = 0.06)。单变量分析表明,PSA患者发生BCR的风险更大 ⩾ 20 ng/mL与GS相比 ⩾ 8(p = 0.05)。研究的局限性包括有限的随访时间和用于分析的BCR数。总体而言,五分之一的高危患者将在4岁时出现BCR 年。然而,那些具有多种风险因素的人的风险显著增加。这有助于就HRPCa治疗中的潜在额外治疗进行咨询。不适用
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pre-operative risk stratification of high-risk prostate cancer patients can predict risk of biochemical recurrence for individual patients post radical surgery: A multi-institutional study
The aim of this study was to identify which high-risk prostate cancer (HRPCa) patients would suffer biochemical recurrence (BCR) after radical prostatectomy (RP), providing a personalised % risk at initial consultation. BCR is more likely in HRPCa; however, the incidence is not equal in this cohort. A total of 850 patients underwent RP for HRPCa in four institutions between 2013 and 2019. Immediate additional treatment post RP was exclusion criteria, leaving 832 patients. Patient demographics, pre-operative, histological features and incidence of BCR (PSA ⩾ 0.2 ng/mL) were recorded. Patients were risk-stratified patients according to having one, two or three high-risk factors. Chi-square test was used for categorical variables. Univariate analysis was performed, and BCR-free survival between groups was explored with Kaplan–Meier method. Median follow-up was 48 months. Overall rate of BCR was 19.8%. Median time to BCR was 19 months. In the risk stratification analysis, 75% of patients had one risk feature. Multiple risk features carried a significantly higher risk of positive surgical margin and incidence of BCR ( p < 0.001), but not time to BCR ( p = 0.06) compared with single features. Univariate analysis demonstrated that the risk of BCR was greater with a PSA ⩾ 20 ng/mL compared to GS ⩾ 8 ( p = 0.05). Limitations of the study include limited follow-up time and BCR numbers for analysis. Overall, one in five high-risk patients will develop BCR by 4 years. However, those with multiple risk factors have a significantly increased risk. This aids the consultation regarding potential additional therapies alongside surgery in the treatment of HRPCa. Not applicable
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来源期刊
Journal of Clinical Urology
Journal of Clinical Urology UROLOGY & NEPHROLOGY-
CiteScore
0.60
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