IS TUMOR VOLUME AN INDEPENDENT PREDICTOR OF PROGRESSION FOLLOWING RADICAL PROSTATECTOMY - A MULTIVARIATE-ANALYSIS OF 185 CLINICAL STAGE-B ADENOCARCINOMAS OF THE PROSTATE WITH 5 YEARS OF FOLLOW-UP
IS TUMOR VOLUME AN INDEPENDENT PREDICTOR OF PROGRESSION FOLLOWING RADICAL PROSTATECTOMY - A MULTIVARIATE-ANALYSIS OF 185 CLINICAL STAGE-B ADENOCARCINOMAS OF THE PROSTATE WITH 5 YEARS OF FOLLOW-UP
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DOI：
10.1016/s0022-5347(17)36421-2
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发表时间：
1993-06-01
影响因子：
6.6
通讯作者：
WALSH, PC
中科院分区：
文献类型：
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作者：
EPSTEIN, JI;CARMICHAEL, M;WALSH, PC
肿瘤体积与Gleason分级、包膜穿透、精囊侵犯、淋巴转移和包膜切除边缘成正比。因为这些变量通常是相互关联的，所以确定这些参数中的哪一个能够独立预测前列腺癌的预后是至关重要的。这项研究分析了185名因临床B期前列腺癌而接受耻骨后放射状前列腺切除术的男性。有精囊侵犯或淋巴结转移的患者被排除在外，因为这些发现几乎总是与进展相关。所有患者在根治性前列腺切除术后至少随访5年。只有2名患者接受了术后辅助治疗。在根治性前列腺切除术后5年，58名男性(31%)经历了进展，表现为术后血清前列腺特异性抗原水平升高、局部复发或远处转移。虽然包膜穿透率、肿瘤体积和肿瘤累及前列腺癌的百分比本身可以预测疾病进展，但在逐步回归分析中，它们不能提供独立的预后信息。在多因素分析中，Gleason评分是预测疾病进展的最好指标(p
Tumor volume has been shown to be proportionate to Gleason grade, capsular penetration, seminal vesicle invasion, lymph node metastases and capsular margins of resection. Because these variables are often interrelated, it is crucial to determine which of these parameters provides independent prediction of prognosis in prostate cancer. The current study analyzed 185 men who underwent radial retropubic prostatectomy for clinical stage B adenocarcinoma of the prostate. Patients with seminal vesicle invasion or lymph node metastases were excluded, since these findings are almost invariably associated with progression. All patients were followed for a minimum of 5 years after radical prostatectomy. Only 2 men received postoperative adjuvant therapy. At 5 years after radical prostatectomy 58 men (31%) experienced progression, defined by either an elevated postoperative serum prostate specific antigen level, local recurrence or distant metastases. Although by themselves capsular penetration, tumor volume and per cent of the prostate involved by tumor predicted progression, in a stepwise regression analysis they did not provide independent prognostic information. In this multivariate analysis Gleason score was the best predictor of progression (p