Evidence to support a continued stage migration and decrease in prostate cancer specific mortality
Evidence to support a continued stage migration and decrease in prostate cancer specific mortality
复制标题
DOI：
10.1016/s0022-5347(05)00419-2
复制
发表时间：
2006-03-01
影响因子：
6.6
通讯作者：
D'Amico, AV
中科院分区：
文献类型：
--
作者：
Galper, SL;Chen, MH;D'Amico, AV
目的：我们评估了术后PSA-DT小于3个月，PCSM的替代品，患者的比例是否显着下降，在PSA的时代，材料和方法：1988年7月至2002年7月，3,719名男性与临床局限性前列腺癌治疗RP组成的研究队列。采用卡方计量法比较早期PSA时代（1988年7月至1995年7月）和晚期PSA时代（1995年8月至2002年7月）2个等分时期内接受治疗的患者的术前和术后特征、5年实际PSA失败率和PSA-DT。在最近的PSA时代出现的患者年龄较轻（p < 0.0001），分期较早（p < 0.0001），疾病级别较低（p = 0.01）。同样，RP患者的分级（p < 0.001）、分期（p < 0.0001）、切缘阳性（p < 0.0001）和淋巴结转移率（p = 0.0002）较低。5年实际PSA失败率从早期PSA时代的14.3%降至晚期PSA时代的2.5%（p < 0.0001）。PSA-DT小于3个月的患者比例降低了37%，对应于两个时期之间绝对幅度从9%降低到5.7%。术后3 ~ 5.99个月和6 ~ 11.99个月PSA-DTs分别减少3.1%和9%，而12个月以上PSA-DTs增加15.3%。结论：在最近的PSA时代，术后PSA失败明显减少，PSA-DTs增加，表明PCSM将继续减少。
Purpose: We evaluated whether the proportion of patients with a postoperative PSA-DT less than 3 months, a surrogate for PCSM, decreased significantly during the PSA era.Materials and Methods: Between July 1988 and July 2002, 3,719 men with clinically localized prostate cancer treated with RP comprised the study cohort. A chi-square metric was used to compare the preoperative and postoperative characteristics, 5-year actual PSA failure rates, and PSA-DTs for patients treated during the 2 equally divided eras of the early PSA era, July 1988 to July 1995 and the late PSA era, August 1995 to July 2002.Results: Patients presenting in the more recent PSA era were of younger age (p < 0.0001), with earlier stage (p < 0.0001) and lower grade disease (p = 0.01). Similarly, patients had lower grade (p < 0.001), stage (p < 0.0001), and positive margin (p < 0.0001) and lymph node rates (p = 0.0002) at RP. The 5-year actual PSA failure rates decreased from 14.3% in the early PSA era to 2.5% in the later PSA era (p < 0.0001). There was a 37% reduction in the proportion of patients with a PSA-DT less than 3 months, corresponding to a decrease in absolute magnitude from 9% to 5.7% between the 2 eras. Absolute reductions of 3.1% and 9% were also noted for the proportion of PSA-DTs of 3 to 5.99 months and 6 to 11.99 months, respectively, whereas PSA-DTs of 12 months or greater increased by 15.3%.Conclusions: During the recent PSA era, postoperative PSA failure has significantly decreased and PSA-DTs have increased, suggesting that PCSM will continue to decrease.