Prostate-specific antigen screening impacts on biochemical recurrence in patients with clinically localized prostate cancer
Prostate-specific antigen screening impacts on biochemical recurrence in patients with clinically localized prostate cancer
复制标题
前列腺特异性抗原筛查对临床局限性前列腺癌患者生化复发的影响
DOI：
10.1111/iju.13563
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发表时间：
2018
影响因子：
2.6
通讯作者：
Ohno Yoshio
中科院分区：
文献类型：
--
作者：
Hashimoto Takeshi;Ohori Makoto;Shimodaira Kenji;Kaburaki Naoto;Hirasawa Yosuke;Satake Naoya;Gondo Tatsuo;Nakagami Yoshihiro;Namiki Kazunori;Ohno Yoshio
目的探讨前列腺特异性抗原筛查对前列腺癌手术预后的影响。方法将行根治性前列腺切除术的患者根据前列腺特异性抗原检测时机分为两组（第1组，前列腺特异性抗原筛查;第2组，非前列腺特异性抗原筛查）。使用Wilcoxon秩和χ2检验比较围手术期临床特征。考克斯比例风险模型被用来确定术后生化无复发survival.ResultsIn总数的独立预测因素，798例患者（63.2%）和464例患者（36.8%）被分为组1和2，分别。第2组患者更可能具有较高的前列腺特异性抗原水平和诊断时的年龄以及较大的前列腺体积。临床T分期、阳性核心百分比和病理Gleason评分在组间无差异。第1组和第2组的5年生化无复发生存率分别为83.9%和71.0%（P< 0.001）。在多变量分析中，前列腺特异性抗原检测机会（风险比2.530;P< 0.001）是术后生化复发以及病理T分期、病理Gleason评分、手术切缘阳性和淋巴血管浸润的独立预测因素。额外的分析表明，前列腺特异性抗原筛查对年轻患者、前列腺特异性抗原水平高、前列腺体积大和D 'Amico高风险患者以及符合前列腺癌研究国际主动监测研究排除标准的患者的生化复发有更大的影响。前列腺特异性抗原筛查可能有助于减少局限性前列腺癌患者的生化复发。
ObjectiveTo clarify the impact of prostate‐specific antigen screening on surgical outcomes of prostate cancer.MethodsPatients who underwent radical prostatectomy were divided into two groups according to prostate‐specific antigen testing opportunity (group 1, prostate‐specific antigen screening; group 2, non‐prostate‐specific antigen screening). Perioperative clinical characteristics were compared using the Wilcoxon rank‐sum and χ2‐tests. Cox proportional hazards models were used to identify independent predictors of postoperative biochemical recurrence‐free survival.ResultsIn total, 798 patients (63.2%) and 464 patients (36.8%) were categorized into groups 1 and 2, respectively. Group 2 patients were more likely to have a higher prostate‐specific antigen level and age at diagnosis and larger prostate volume. Clinical T stage, percentage of positive cores and pathological Gleason score did not differ between the groups. The 5‐year biochemical recurrence‐free survival rate was 83.9% for group 1 and 71.0% for group 2 (P< 0.001). On multivariate analysis, prostate‐specific antigen testing opportunity (hazard ratio 2.530;P< 0.001) was an independent predictive factor for biochemical recurrence after surgery, as well as pathological T stage, pathological Gleason score, positive surgical margin and lymphovascular invasion. Additional analyses showed that prostate‐specific antigen screening had a greater impact on biochemical recurrence in a younger patients, patients with a high prostate‐specific antigen level, large prostate volume and D'Amico high risk, and patients meeting the exclusion criteria of the Prostate Cancer Research International Active Surveillance study.ConclusionsDetection by screening results in favorable outcomes after surgery. Prostate‐specific antigen screening might contribute to reducing biochemical recurrence in patients with localized prostate cancer.