Prostate cancer specific mortality and Gleason 7 disease differences in prostate cancer outcomes between cases with Gleason 4 + 3 and Gleason 3 + 4 tumors in a population based cohort.
Prostate cancer specific mortality and Gleason 7 disease differences in prostate cancer outcomes between cases with Gleason 4 + 3 and Gleason 3 + 4 tumors in a population based cohort.
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DOI：
10.1016/j.juro.2009.08.026
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发表时间：
2009-12
期刊：
影响因子：
--
通讯作者：
Stanford JL
中科院分区：
文献类型：
--
作者：
Wright JL;Salinas CA;Lin DW;Kolb S;Koopmeiners J;Feng Z;Stanford JL
关于前列腺癌（PCa）初次治疗后生化复发的报告显示Gleason 4+3和3+4肿瘤之间存在差异。这些结果尚未用于PCA特异性死亡率（PCSM）。在这个基于人群的队列中，我们确定了不同Gleason评分，特别是不同Gleason 7模式下的PCa结局。1993-1996年在华盛顿金郡诊断为PCa的40-64岁男性组成了该队列。通过随访调查和病历审查确定复发/进展。死亡率和死亡原因来自SEER登记研究。结果用考克斯比例风险回归分析确定。在753例PCa患者中，65例PCa特异性死亡发生在中位随访13.2年期间。Gleason ≤6、3+4、4+3和8-10的10年PCA特异性生存率分别为98.4%、92.1%、76.5%和69.9%。与Gleason 3+4疾病患者相比，Gleason 4+3肿瘤患者在未校正（HR 2.80，95%CI 1.26 - 6.18）和多变量模型（HR 2.12，95%CI 0.87-5.17，p=0.1）中PCSM风险增加。在接受根治性乳腺癌切除术或放射治疗的男性中，与多变量模型中的3+4肿瘤相比，Gleason 4+3肿瘤患者的复发/进展（HR 2.1，95% CI 1.1-4.0）和PCSM（HR 3.2，95% CI 1.0-9.7）风险增加。Gleason 4+3和8 - 10肿瘤的PCSM无差异。Gleason 7 PCa肿瘤表现出异质性行为，Gleason 3+4和4+3肿瘤赋予不同的PCSM。这些数据为咨询Gleason 7 PCa患者的疾病自然史提供了重要信息，并可能为治疗决策提供信息。
Reports on biochemical recurrence after prostate cancer (PCa) primary therapy have shown differences between Gleason 4+3 and 3+4 tumors. These findings have not been explored for PCa-specific mortality (PCSM). In this population-based cohort, we determine PCa outcomes at different Gleason scores, in particular the different Gleason 7 patterns. Men aged 40–64 diagnosed with PCa between 1993–1996 in King County, Washington comprised the cohort. Recurrence/progression was determined by follow-up survey and medical records review. Mortality and cause of death were obtained from the SEER registry. Outcomes were determined with Cox proportional hazards regression analysis. Of 753 men with PCa, 65 PCa-specific deaths occurred during a median follow-up of 13.2 years. The 10-year PCa-specific survival rates for Gleason ≤6, 3+4, 4+3, and 8–10 were 98.4%, 92.1%, 76.5% and 69.9%, respectively. Compared to patients with Gleason 3+4 disease, those with Gleason 4+3 tumors had an increased risk of PCSM in both the unadjusted (HR 2.80, 95%CI 1.26 – 6.18) and multivariate models (HR 2.12, 95% CI 0.87–5.17, p=0.1). In men undergoing curative therapy with radical prostatectomy or radiation therapy, there was an increased risk of recurrence/progression (HR 2.1, 95% CI 1.1–4.0) and PCSM (HR 3.2, 95% CI 1.0–9.7) in those with Gleason 4+3 compared to 3+4 tumors in the multivariate models. No difference in PCSM was seen between Gleason 4+3 and 8 – 10 tumors. Gleason 7 PCa tumors exhibit a heterogeneous behavior with Gleason 3+4 and 4+3 tumors conferring different PCSM. These data provide important information for counseling patients with Gleason 7 PCa on the natural history of their disease and may inform treatment decisions.
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影响因子：
45.3
作者：
Stephenson, Andrew J.;Kattan, Michael W.;Scardino, Peter T.
通讯作者：
Scardino, Peter T.
接受保守治疗的局限性前列腺癌男性的长期结果。
影响因子：
8.8
作者：
Cuzick, J.;Fisher, G.;Kattan, M. W.;Berney, D.;Oliver, T.;Foster, C. S.;Moller, H.;Reuter, V.;Fearn, P.;Eastham, J.;Scardino, P.
通讯作者：
Scardino, P.
影响因子：
2.1
作者：
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通讯作者：
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影响因子：
6.2
作者：
Rasiah, KK;Stricker, PD;Henshall, SM
通讯作者：
Henshall, SM
影响因子：
120.7
作者：
Albertsen, PC;Hanley, JA;Fine, J
通讯作者：
Fine, J