Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer.
Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer.
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DOI：
10.1007/s00345-008-0242-7
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发表时间：
2008-06
影响因子：
3.4
通讯作者：
Hulsbergen-vandeKaa, C. A.
中科院分区：
文献类型：
--
作者：
van Oort, I. M.;Witjes, J. A.;Kok, D. E. G.;Kiemeney, L. A. L. M.;Hulsbergen-vandeKaa, C. A.
先前的研究表明，最大肿瘤直径（MTD）是前列腺癌（PC）复发的预测因子。本研究探讨了MTD对PC患者根治性前列腺切除术（RP）后生化复发（BCR）的预后价值，重点是高危局限性前列腺癌。对542例患者的RP标本进行了中位随访39.5个月（范围0.6-150个月）的评价。MTD定义为最大肿瘤的最大直径;高危定义为≥ T2 c或PSA水平> 20 ng/ml或Gleason评分≥8; BCR定义为连续两次PSA水平> 0.10 ng/ml。组成比例风险多变量回归模型以确定BCR的预后因素。总体而言，114例患者在RP后发生BCR。BCR的总体5年风险为25%（95% CI = 20.4-29.6），中位MTD为24 mm（范围1-65）。总风险组和高风险组的MTD与总肿瘤体积、最大肿瘤体积、术前PSA水平和Gleason评分相关。在单变量分析中，总组中MTD与BCR风险弱相关（HR = 1.02/mm增加，95%CI = 1.002-1.035，P = 0.024）;在高风险组中，这种相关性丢失（HR = 1.01，95%CI = 0.99-1.03，P = 0.18）。多因素分析表明，无论风险状况如何，手术切缘阳性、较高的Gleason评分、晚期病理分期和多发肿瘤是BCR的主要预后因素。MTD未提供更多信息。在RP治疗的患者中，MTD不是BCR的独立预后因素，与风险特征无关。
Previous studies suggest that maximum tumor diameter (MTD) is a predictor of recurrence in prostate cancer (PC). This study investigates the prognostic value of MTD for biochemical recurrence (BCR) in patients with PC, after radical prostatectomy (RP), with emphasis on high-risk localized prostate cancer. RP specimens of 542 patients were evaluated with a median follow-up of 39.5 months (range 0.6–150 months). MTD was defined as the largest diameter of the largest tumor; high-risk as ≥T2c or PSA level > 20 ng/ml or Gleason score ≥8 and BCR as two consecutive PSA levels > 0.10 ng/ml. Proportional hazards multivariable regression models were composed to determine prognostic factors for BCR. Overall, 114 patients developed BCR after RP. The overall 5-year risk of BCR was 25% (95% CI = 20.4–29.6), and median MTD was 24 mm (range 1–65). MTD in the total and high-risk group was associated with total tumor volume, volume of the largest tumor, pre-operative PSA levels, and Gleason score. In a univariable analyses, MTD was weakly associated with risk of BCR (HR = 1.02 per mm increase, 95% CI = 1.002–1.035, P = 0.024) in the total group; in the high-risk group this association was lost (HR = 1.01, 95%CI = 0.99–1.03, P = 0.18). Multivariable analyses indicated that positive surgical margins, higher Gleason score, advanced pathological stage, and multiple tumors were the main prognostic factors for BCR irrespective of the risk profile. MTD did not provide additional information. MTD is not an independent prognostic factor for BCR in patients treated with RP, irrespective of the risk profile.
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影响因子：
2.1
作者：
Dvorak, T;Chen, MH;D'Amico, AV
通讯作者：
D'Amico, AV
影响因子：
3.5
作者：
Eichelberger, LE;Koch, MO;Cheng, L
通讯作者：
Cheng, L
影响因子：
3.3
作者：
Qian, JQ;Wollan, P;Bostwick, DG
通讯作者：
Bostwick, DG
影响因子：
23.4
作者：
Salomon, L;Levrel, O;Abbou, CC
通讯作者：
Abbou, CC
影响因子：
6.6
作者：
EPSTEIN, JI;CARMICHAEL, M;WALSH, PC
通讯作者：
WALSH, PC