Characterization of biochemical recurrence after radical prostatectomy
Characterization of biochemical recurrence after radical prostatectomy
复制标题
DOI：
10.1159/000093906
复制
发表时间：
2006-01-01
影响因子：
1.6
通讯作者：
Pruthi, Raj S.
中科院分区：
文献类型：
--
作者：
Molitierno, Joseph;Evans, Aubrey;Pruthi, Raj S.
背景：本研究旨在描述预测根治性前列腺切除术（RP）失败患者术后前列腺特异性抗原倍增时间（PSAIDT）和生化复发时间（RT）的变量。方法：共有477例临床局限性前列腺癌患者在我们机构接受了RP。在这些患者中，64例（13.4%）表现出术后生化失败的证据。计算所有患者的PSADT和生化RT。PSAIDT和RT与临床变量相关，包括术前PSA水平，患者年龄，种族，前列腺重量和手术标本的病理特征，使用单因素和多因素分析。此外，PSADT和RT也相互相关，并与术后辅助治疗的时间相关。结果：根治性膀胱切除术后复发患者的中位术后PSAIDT为9.7个月。术后PSADT与淋巴结转移（p < 0.001）和Gleason分级（p = 0.06）有关。快速PSAIDT也与术后辅助治疗相关（p = 0.003）。所有患者的中位生化RT为6.7个月。Gleason分级和病理分期是RT的预测因素（p < 0.002）。术后PSADT与RT无关（r = 0.08; p = 0.53）。PSADT和RT在白人与非洲裔美国人之间没有差异。结论：这些结果有助于更好地描述我们的患者队列，这些患者在根治性直肠癌切除术后有生化复发的证据。复发性疾病（即PSADT）的侵袭性似乎可以通过淋巴结受累和较高的病理分级来预测。此外，RT和PSADT缺乏相关性表明早期复发不一定是侵袭性肿瘤：相反，侵袭性复发可能发生在术后的任何时间点。这些信息可能有助于复发性疾病的术后治疗，并有助于更好地确定那些临床复发风险较高的患者，以及那些在术后期间提高警惕的患者。版权所有（c）2006 S. Karger AG，巴塞尔
Background:This study sought to characterize the variables that predict postoperative prostate-specific antigen doubling time (PSAIDT) and biochemical recurrence time (RT) in patients who have failed radical prostatectomy (RP). Methods: A total of 477 patients underwent RP at our institution for clinically localized prostate cancer. Of these patients, 64 (13.4%) demonstrated evidence of postoperative biochemical failure. PSADT and biochemical RT were calculated for all patients. PSAIDT and RT were correlated with clinical variables including preoperative PSA level, patient age, race, prostate weight and with pathologic characteristics of the operative specimen using uni- and multivariate analyses. In addition, PSADT and RT were also correlated with each other and with the time to postoperative adjuvant therapy. Results: Median postoperative PSAIDT for patients who recurred after radical prostatectomy was 9.7 months. Postoperative PSADT was predicted by lymph node involvement (p < 0.001) and Gleason grade (p = 0.06). Rapid PSAIDT also correlated with institution of postoperative adjuvant therapy (p = 0.003). Median biochemical RT for all patients was 6.7 months. Gleason grade and pathologic stage were found to be predictors of RT (p < 0.002). Postoperative PSADT did not correlate with RT (r = 0.08; p = 0.53). PSADT and RT were not different between Caucasian- versus African-Americans. Conclusions: These results serve to better characterize our cohort of patients who have evidence of biochemical recurrence after radical prostatectomy. Aggressiveness of recurrent disease (i.e. PSADT) seems to be predicted by lymph node involvement and higher pathologic grade. Furthermore, the lack of correlation of RT and PSADT suggests that early recurrences are not necessarily aggressive tumors: conversely, aggressive recurrences may occur at any point in the postoperative period. This information may aid in the postoperative treatment of recurrent disease and help to better define those patients who are at higher risk for developing clinical recurrence and who would benefit from greater vigilance during the postoperative period. Copyright (c) 2006 S. Karger AG, Basel