Role of androgen deprivation therapy for node-positive prostate cancer.
Role of androgen deprivation therapy for node-positive prostate cancer.
复制标题
雄激素剥夺疗法对淋巴结阳性前列腺癌的作用。
DOI：
10.1200/jco.2007.14.2042
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
K. Armstrong
中科院分区：
文献类型：
--
作者：
Y. Wong;S. Freedland;B. Egleston;G. Hudes;J. Schwartz;K. Armstrong
目的
确定在前列腺特异性抗原（PSA）时代，辅助雄激素剥夺治疗（ADT）对淋巴结阳性前列腺癌患者的影响。
患者和方法
我们使用相关的监测、流行病学和最终结果-医疗保险数据，构建了一个在1991年至1999年期间接受根治性直肠癌切除术（RP）并具有阳性区域淋巴结的男性队列。如果男性在RP后120天内接受ADT，我们将其归类为接受ADT辅助治疗，并将其与未接受ADT辅助治疗的男性进行比较。我们使用倾向评分来平衡接受辅助ADT的潜在混杂因素（即肿瘤特征、淋巴结疾病程度、人口统计学、接受放射治疗），并使用考克斯比例风险方法来衡量辅助ADT对总生存期（OS）的影响，按倾向评分五分位数分层。我们进行了敏感性分析，使用90、150、180和365天作为辅助ADT的定义。
结果
共确定了731例男性，其中209例在RP后120天内接受ADT治疗。辅助ADT组和非ADT组之间的OS无统计学显著差异（HR，0.97; 95% CI，0.71 - 1.27）。90、150、180和365天作为辅助ADT定义的生存期差异无统计学意义。
结论
在RP后淋巴结阳性的男性中，延迟立即ADT可能不会显著影响生存率。由于观察性研究应被视为产生假设的研究，因此这些结果应在类似患者人群中以前瞻性方式进行验证。
PURPOSE
To determine the impact of adjuvant androgen deprivation therapy (ADT) for patients who have node-positive prostate cancer in the prostate-specific antigen (PSA) era.
PATIENTS AND METHODS
We used linked Surveillance, Epidemiology and End Results-Medicare data to construct a cohort of men who underwent radical prostatectomy (RP) between 1991 and 1999 and who had positive regional lymph nodes. We classified men as receiving adjuvant ADT if they received ADT within 120 days of RP, and we compared them to the men who had not received adjuvant ADT. We used propensity scores to balance potential confounders of receiving adjuvant ADT (ie, tumor characteristics, extent of nodal disease, demographics, receipt of radiation therapy) and Cox proportional hazard methods to measure the impact of adjuvant ADT on overall survival (OS), stratified by propensity score quintile. We conducted a sensitivity analysis that used 90, 150, 180, and 365 days as the definition for adjuvant ADT.
RESULTS
A total of 731 men were identified, 209 of whom received ADT within 120 days of RP. There was no statistically significant difference in OS between the adjuvant ADT and non-ADT group (HR, 0.97; 95% CI, 0.71 to 1.27). There was no statistically significant survival difference with 90, 150, 180, and 365 days as the adjuvant ADT definition.
CONCLUSION
Deferring immediate ADT in men with positive lymph nodes after RP may not significantly compromise survival. Because observational studies should be considered hypothesis-generating studies, these results should be validated in a prospective fashion in a similar patient population.
DOI：
10.1016/s0022-5347(05)00388-5
发表时间：
2005-07
期刊：
JAMA
影响因子：
--
作者：
S. Freedland;E. Humphreys;L. Mangold;M. Eisenberger;F. Dorey;P. Walsh;A. Partin
通讯作者：
S. Freedland;E. Humphreys;L. Mangold;M. Eisenberger;F. Dorey;P. Walsh;A. Partin
影响因子：
51.1
作者：
Messing, Edward M.;Manola, Judith;Trump, Donald
通讯作者：
Trump, Donald
影响因子：
120.7
作者：
Pound, CR;Partin, AW;Walsh, PC
通讯作者：
Walsh, PC