Castration-resistant prostate cancer without metastasis at presentation may achieve cancer-specific survival in patients who underwent prior radical prostatectomy
Castration-resistant prostate cancer without metastasis at presentation may achieve cancer-specific survival in patients who underwent prior radical prostatectomy
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DOI：
10.1007/s11255-019-02339-3
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发表时间：
2020-01-03
影响因子：
2
通讯作者：
Ohyama, Chikara
中科院分区：
文献类型：
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作者：
Kodama, Hirotake;Koie, Takuya;Ohyama, Chikara
目的 对于前列腺癌 (PCa) 患者，根治性前列腺切除术 (RP) 的肿瘤学结果相对较好。然而，RP 后生化复发 (BCR) 患者的去势抵抗性 PCa (CRPC) 发生率和 PCa 特异性死亡率仍不清楚。本研究的目的是评估 RP 后 CRPC 患者的癌症特异性生存 (CSS)，特别是那些有或没有转移的患者。方法我们回顾性分析了1996年7月至2019年1月连续1582例接受RP的患者的资料。入组患者均经组织学证实为T1a-T3b期PCa，无淋巴结受累或远处转移。终点是诊断 CRPC 时有或无转移的 PCa 患者的肿瘤学结果，包括 CSS 和 BCR。结果共有1474名患者纳入本研究。截至随访期结束，入组患者中 352 例（24.6%）在 RP 后达到 BCR。共有 42 名患者（2.9%）发生 CRPC，18 名患者（1.3%）死于 PCa。对于诊断为CRPC的患者的转移，RP后非转移性CRPC（nmCRPC）患者的5年CSS率为100％，转移性CRPC（mCRPC）患者为53.8％。诊断为 CRPC 后，nmCRPC 患者的 5 年 CSS 率为 100%，mCRPC 患者的 5 年 CSS 率为 27.1%。结论 CRPC是PCa死亡的致命原因之一。然而，对于 RP 后的 PCa 患者，nmCRPC 可能会取得相对较好的预后。
Purpose Radical prostatectomy (RP) is relatively better oncological outcomes in patients with prostate cancer (PCa). However, the incidence of castration-resistant PCa (CRPC) and PCa-specific mortality in patients with biochemical recurrence (BCR) after RP remains unclear. The aim of this study was to evaluate the cancer-specific survival (CSS) in patients with CRPC after RP, in particular those who had metastases or not. Methods We retrospectively reviewed the data of 1582 consecutive patients who underwent RP between July 1996 and January 2019. The enrolled patients had histologically confirmed stage T1a-T3b PCa without lymph node involvement or distant metastasis. The endpoints were oncological outcomes, including CSS and BCR, in patients with PCa with or without metastases at the time of diagnosis with CRPC. Results A total of 1474 patients were enrolled in this study. By the end of the follow-up period, 352 patients (24.6%) in the enrolled patients had BCR after RP. A total of 42 patients (2.9%) developed CRPC and 18 (1.3%) had died of PCa. With regard to metastasis in patients who diagnosed CRPC, the 5-year CSS rate was 100% for nonmetastatic CRPC (nmCRPC) patients and 53.8% for metastatic CRPC (mCRPC) patients after RP. The 5-year CSS rate was 100% for nmCRPC patients and 27.1% for mCRPC patients after the diagnosis with CRPC. Conclusions CRPC is one of the lethal causes with PCa death. However, nmCRPC may achieve relatively good prognosis in patients with PCa after RP.