Clinical course of early onset prostate cancer with special reference to family history as a prognostic factor
Clinical course of early onset prostate cancer with special reference to family history as a prognostic factor
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DOI：
10.1159/000019672
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发表时间：
1998-07-01
期刊：
影响因子：
23.4
通讯作者：
Lundgren, R
中科院分区：
文献类型：
--
作者：
Bratt, O;Kristoffersson, U;Lundgren, R
目的：本研究的目的是描述早发性前列腺癌的临床特征，特别是家族史作为一个可能的预后因素。材料和方法：我们确定了1958年至1994年瑞典南部卫生保健地区51岁以前诊断的所有前列腺癌病例。从病历中回顾性收集临床数据。有关前列腺癌家族史的数据也从教区当局和地区癌症登记处收集。结果：共纳入89例。中位随访时间为17年。在随访期间，65名患者死亡，其中57人死于前列腺癌。在诊断时，34%的患者有局限性，22%有局部进展，40%有转移性肿瘤。肿瘤分化良好的情况下，30%，中度分化的38%，低分化的28%。3例病例的肿瘤分级和分期信息缺失。5年和10年的病因特异性生存率分别为48%和29%。18例有前列腺癌家族史的患者的预后略好于阴性家族史的患者，但差异未达到统计学显著性（p = 0.08）。结论：早发性前列腺癌是一种严重的疾病，死亡率高。低分化和转移性肿瘤患者的比例似乎大于在生命后期诊断的病例，但这可以通过选择偏倚来解释，因为年轻男性诊断出无症状局部肿瘤的可能性较低。前列腺癌家族史与预后无显著相关性。
Objective: The aim of this study was to describe the clinical characteristics of early onset prostate cancer, with special reference to family history as a possible prognostic factor. Material and Methods: We identified all cases of prostate cancer diagnosed before the age of 51 in the Southern health care region in Sweden between 1958 and 1994. Clinical data were collected retrospectively from medical records. Data about family history of prostate cancer were also collected from the parish authorities and the Regional Cancer Registry. Results: In all, 89 cases were included. The median time of follow-up was 17 years. During the time of follow-up, 65 patients died, 57 of whom died from prostate cancer. At diagnosis, 34% of the patients had localized, 22% had locallly advanced, and 40% had metastatic tumours. The tumours were well differentiated in 30% of the cases, moderately differentiated in 38%, and poorly differentiated in 28%. Information on tumour grade and stage was missing in 3 cases. The cause-specific survival was 48% at 5 years and 29% at 10 years. The 18 patients with a family history of prostate cancer had a somewhat better prognosis than the patients with a negative family history, though the difference did not reach statistical significance (p = 0.08). Conclusions: Early onset prostate cancer is a serious disease with high mortality. The proportions of patients with poorly differentiated and metastatic tumours appeared to be larger than for cases diagnosed later in life, but this could be explained by selection bias since younger men may have a lower probability of having asymptomatic localized tumours diagnosed. Family history of prostate cancer was not significantly associated with prognosis.