Changes in indications and oncological outcomes of radical prostatectomy after 2000--data from 1268 Japanese patients treated with radical prostatectomy between 2000 and 2009.
Changes in indications and oncological outcomes of radical prostatectomy after 2000--data from 1268 Japanese patients treated with radical prostatectomy between 2000 and 2009.
复制标题
2000年后根治性前列腺切除术适应症和肿瘤学结果的变化——来自2000年至2009年间接受根治性前列腺切除术的1268名日本患者的数据。
DOI：
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发表时间：
2013
影响因子：
2.4
通讯作者：
Y. Arai
中科院分区：
文献类型：
--
作者：
K. Mitsuzuka;T. Koie;S. Narita;Y. Kaiho;T. Yoneyama;N. Tsuchiya;N. Kakoi;S. Kawamura;T. Tochigi;C. Ohyama;T. Habuchi;Takuhiro Yamaguchi;Y. Arai
客观的
该研究的目的是描述 2000 年后根治性前列腺切除术的适应症和肿瘤学结果的趋势。
方法
回顾性分析了 2000 年至 2009 年间在日本四个泌尿中心接受根治性前列腺切除术且未接受新辅助治疗的 1268 名患者的数据。分析了根治性前列腺切除术年龄、前列腺特异性抗原水平、活检格里森评分、临床 T 分期、D'Amico 风险分类、器官局限性疾病和手术标本中肿瘤体积随时间的变化。
结果
根治性前列腺切除术的中位年龄从2000-2年的68岁下降到2009年的65岁（P < 0.001）。在整个研究期间，大约63.3%的患者年龄≥65岁，31.4%的患者年龄≥70岁。前列腺特异性抗原中位水平从2000年2月的8.61 ng/ml下降到2009年的6.90 ng/ml（P < 0.001）。器官局限性疾病的发生率从2000-2年的52.8%上升到2009年的72.5%（P = 0.004）。中位肿瘤体积从2000年2月的1.70 cc减少到2009年的1.28 cc（P = 0.017）。活检Gleason评分7级的比例从2000-2年的40.6%上升到2009年的60.1%（P < 0.001），中危组的比例从2000-2年的39.5%上升到2009年的59.5%（P < 0.001）。
结论
日本局限性前列腺癌男性接受根治性前列腺切除术的年龄高于美国或欧洲。前列腺特异性抗原、非器官局限性疾病和肿瘤体积在研究期间减少，而格里森评分7和中等风险疾病在研究期间增加。这些信息可以对不同治疗之间、不同地理区域之间以及不同时间段之间的结果进行比较。
OBJECTIVE
The aim of the study was to characterize trends in indications for and oncological outcomes of radical prostatectomy after 2000.
METHODS
Data from 1268 patients undergoing radical prostatectomy without neoadjuvant therapy between 2000 and 2009 at four urological centers in Japan were retrospectively reviewed. Changes in age at radical prostatectomy, prostate-specific antigen level, biopsy Gleason score, clinical T stage, D'Amico risk classification, organ-confined disease and tumor volume in surgical specimens were analyzed over time.
RESULTS
The median age at radical prostatectomy decreased from 68 years in 2000-2 to 65 years in 2009 (P < 0.001). Approximately 63.3% of patients were ≥65 years old, and 31.4% of patients were ≥70 years old during the whole study period. The median prostate-specific antigen level decreased from 8.61 ng/ml in 2000-2 to 6.90 ng/ml in 2009 (P < 0.001). The rate of organ-confined disease increased from 52.8% in 2000-2 to 72.5% in 2009 (P = 0.004). The median tumor volume decreased from 1.70 cc in 2000-2 to 1.28 cc in 2009 (P = 0.017). The proportion of biopsy Gleason score 7 increased from 40.6% in 2000-2 to 60.1% in 2009 (P < 0.001), and the proportion of the intermediate-risk group increased from 39.5% in 2000-2 to 59.5% in 2009 (P < 0.001).
CONCLUSIONS
Age at radical prostatectomy for men with localized prostate cancer was higher in Japan than in the USA or Europe. Prostate-specific antigen, non-organ-confined disease and tumor volume decreased during the study period, whereas Gleason score 7 and intermediate-risk disease increased during the study period. This information enables comparison of outcomes between various treatments, between various geographic regions and between various time periods.
影响因子：
10.3
作者：
Shao, Yu-Hsuan;Demissie, Kitaw;Lu-Yao, Grace L.
通讯作者：
Lu-Yao, Grace L.