临床局部晚期前列腺癌患者长期根治性前列腺切除术的肿瘤预后:一项单中心研究

Q3 Medicine

Experimental oncology Pub Date : 2022-05-01 DOI:10.32471/exp-oncology.2312-8852.vol-44-no-1.17436

V. Grygorenko, Yevhen Afanasiev, R. Danylets, M. Vikarchuk, M. Kosyuchno, S. Pasichnyk

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引用次数: 0

摘要

背景:前列腺癌(PCa)是全球男性中第二大最常诊断的癌症，在男性癌症死亡率中排名第五。14-24%的PCa患者新诊断为晚期，矛盾的是，随着时间的推移，这一比例一直保持稳定。目的评估和比较临床局部晚期前列腺癌(LAPCa)患者根治性前列腺切除术(RP)的长期肿瘤预后，以确定常见的临床病理参数对预后的意义。患者和方法该研究纳入了2003年9月至2015年4月期间接受RP合并盆腔淋巴结切除术的105例LAPCa患者。Kaplan - Meier法计算生化复发率(BRFS)、无进展率(PFS)、总生存率(OS)和前列腺癌特异性生存率(PCSS)。使用Cox比例风险回归模型分析与结果相关的特征。结果cT3b组患者的PFS、OS和PCSS率均低于cT3a组，而BRFS率差异无统计学意义。术前血清前列腺特异性抗原水平(危险比(HR) 1.023, 95%可信区间(CI): 1.014-1.033, p < 0.001)、pT3a (HR 3,027, 95% CI: 1.449-7.096, p < 0.01)、pT3b (HR 2.792, 95% CI: 1.133-6.881, p < 0.05)、pT4分期(HR 31.12, 95% CI: 7.646-126.6 p < 0.001)和淋巴结阳性状态(HR 6.503, 95% CI: 3.190-13.25, p < 0.001)是BRFS的显著因素。术前血清前列腺特异性抗原水平(HR 1.018, 95% CI: 1.007 ~ 1.030, p = 0.001)和淋巴结阳性状态(HR 3.191, 95% CI: 1.672 ~ 6.088, p < 0.001)是PFS和PCSS的显著影响因素。结论srp作为多模式治疗LAPCa患者的初始治疗选择，具有良好的肿瘤预后。与cT3a组相比，cT3b组患者的PFS、OS和PCSS发生率更低。LAPCa患者预后的异质性反映了现有临床风险分类在预测全身进展和癌症特异性生存方面的不足。

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LONG-TERM RADICAL PROSTATECTOMY ONCOLOGIC OUTCOMES IN PATIENTS WITH CLINICALLY LOCALLY ADVANCED PROSTATE CANCER: A SINGLE-CENTER STUDY.

BACKGROUND Prostate cancer (PCa) is the second most frequently diagnosed cancer in males worldwide and placed fifth in cancer mortality among males. Between 14-24% of PCa patients have newly diagnosed advanced stages, which paradoxically has remained stable over time. AIM To estimate and compare long-term radical prostatectomy (RP) oncologic outcomes in patients with clinically locally advanced prostate cancer (LAPCa), to determine the prognostic significance of common clinical-pathological parameters. PATIENTS AND METHODS The study included 105 patients with LAPCa who underwent RP with extended pelvic lymphadenectomy between September 2003 - April 2015. Kaplan - Meier method was used for calculating biochemical recurrence- (BRFS), progression-free- (PFS), overall (OS), and prostate cancer-specific survival (PCSS) rates. Analyses of features associated with outcomes were conducted using Cox proportional hazards regression model. RESULTS Patients from cT3b group had worse PFS, OS and PCSS rates in comparison with cT3a, while there was no significant difference in BRFS rates. Preoperative serum prostate-specific antigen level (hazard ratio (HR) 1.023, 95% confidence interval (CI): 1.014-1.033, p < 0.001), pT3a (HR 3,027, 95% CI: 1.449-7.096, p < 0.01), pT3b (HR 2.792, 95% CI: 1.133-6.881, p < 0.05) pT4 stage (HR 31.12, 95% CI: 7.646-126.6 p < 0.001) and positive lymph nodes status (HR 6.503, 95% CI: 3.190-13.25, p < 0.001) were significant factors in BRFS. Preoperative serum prostate-specific antigen level (HR 1.018, 95% CI: 1.007-1.030, p = 0.001) and positive lymph nodes status (HR 3.191, 95% CI: 1.672-6.088, p < 0.001) were significant factors in PFS and PCSS. CONCLUSIONS RP as the initial treatment option of multimodal therapy in the management of LAPCa patients demonstrates encouraging oncologic outcomes. Patients from the cT3b group had the worse rates of PFS, OS, and PCSS in comparison with the cT3a group. Heterogeneity of LAPCa patients' outcomes reflects the insufficiency of the existing clinical risk classification for the prediction of systemic progression and cancer-specific survival.

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来源期刊

Experimental oncology Medicine-Oncology

CiteScore

1.40

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0.00%

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期刊介绍： The Experimental Oncology is an English-language journal that publishes review articles, original contributions, short communications, case reports and technical advances presenting new data in the field of experimental and fundamental oncology. Manuscripts should be written in English, contain original work, which has not been published or submitted for publication elsewhere. It also implies the transfer of the Copyright from the author to “Experimental Oncology”. No part of journal publications may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission of the publisher.