Era specific biochemical recurrence-free survival following radical prostatectomy for clinically localized prostate cancer
Era specific biochemical recurrence-free survival following radical prostatectomy for clinically localized prostate cancer
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DOI：
10.1016/s0022-5347(05)65955-1
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发表时间：
2001-08-01
影响因子：
6.6
通讯作者：
Walsh, PC
中科院分区：
文献类型：
--
作者：
Han, M;Partin, AW;Walsh, PC
目的：我们回顾性分析了一个大型系列的男性临床局限性前列腺癌谁接受手术，以确定阶段迁移的程度和生化复发的影响，在3个不同时代的前列腺癌management.Materials和方法：共2,370名男性进行了根治性前列腺切除术，从1982年至1998年。我们分析了根治性前列腺切除术后生化（前列腺特异性抗原）进展的自由。我们比较了按手术年份划分的病理分期分布。然后，我们比较了生化无复发生存率，根据不同的时代，反映了前列腺癌management.Results的变化：有一个显着的向下阶段的前列腺癌的迁移和越来越多的比例的男性谁提出的器官局限性疾病在最近几年。与1989年至1998年相比，1982年至1988年接受手术的患者的精算生化无复发率有显著差异（p < 0.001）。这些变化可能反映了前列腺特异性抗原和直肠指检的早期检测的好处，更好的术前选择的患者进行手术，以及lead time.Conclusions的效果：广泛的前列腺癌早期检测程序导致下行阶段迁移的男性在过去的18年中，在我们的机构与前列腺癌。此外，我们已经证明了一个生化无复发生存优势，可能是次要的改善治疗效果以及前置时间的偏见，在男性谁接受手术之间的1989年和1998年，与那些在1982年和1988年。当试图比较前列腺癌不同治疗方式的疗效时，患者接受治疗的时代是需要考虑的重要因素。
Purpose: We retrospectively reviewed a large series of men with clinically localized prostate cancer who underwent surgery to define the extent of stage migration and its influence on biochemical recurrence in 3 different eras of prostate cancer management.Materials and Methods: A total of 2,370 men were treated with radical prostatectomy from 1982 to 1998. We analyzed the freedom from biochemical (prostate specific antigen) progression after radical prostatectomy. We compared the distribution of pathological stage by the year of surgery. We then compared the biochemical recurrence-free survival rate according to the different eras that reflect a change in prostate cancer management.Results: There was a significant downward stage migration of prostate cancer and an increasing proportion of men who presented with Organ confined disease in recent years. The actuarial biochemical recurrence-free rate was significantly different for patients who underwent surgery between 1982 and 1988, compared with those between 1989 and 1998 (p < 0.001). These changes may have reflected the benefits of early detection with prostate specific antigen and digital rectal examination, better preoperative selection of patients for surgery as well as the effect of lead time.Conclusions: Widespread early detection programs for prostate cancer resulted in downward stage migration in men presenting with prostate cancer at our institution during the last 18 years. Also, we have demonstrated a biochemical recurrence-free survival advantage, probably secondary to an improved therapeutic outcome as well as lead time bias, in men who underwent surgery between 1989 and 1998, compared with those between 1982 and 1988. When trying to compare the efficacy of different treatment modalities for prostate cancer, the era in which patients underwent therapy is an important factor to be considered.