Oncological Outcome of Cytoreductive Radical Prostatectomy in Prostate Cancer Patients With Bone Oligometastases
Oncological Outcome of Cytoreductive Radical Prostatectomy in Prostate Cancer Patients With Bone Oligometastases
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DOI：
10.1016/j.urology.2019.03.040
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发表时间：
2019-09-01
期刊：
影响因子：
2.1
通讯作者：
Ye, JianJun
中科院分区：
文献类型：
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作者：
Lan, Tian;Chen, Ye;Ye, JianJun
目的探讨细胞减少性前列腺癌根治术(CRP)在治疗局部可切除和远处转移的前列腺癌(CAP)中的作用。方法和方法将99mTc骨显像发现5个或5个以下转移灶，且显像前无可疑脏器受累定义为前列腺癌。对2005-2016年间在本中心连续确诊的111例少发转移性帽子患者的临床资料进行回顾性分析。在这项回顾性队列研究中，35名患者接受了C反应蛋白和雄激素剥夺治疗，76名患者仅接受雄激素剥夺治疗。肿瘤预后采用Kaplan-Meier方法进行分析。结果两组患者的平均随访时间为35个月。在整个队列分析中，前列腺特异性抗原(PSA)下降速度(P=.167)、PSA半衰期(P=.263)和PSA最低值(P=.196)在两组间无显著差异。同时，在PSA无复发存活率(P=.184)、临床无进展存活率(P=.118)和癌症特异性存活率(P=.773)方面，两组之间的肿瘤学结果差异没有达到统计学意义。此外，在预先指定的亚组分析中也观察到了类似的结果(低PSA组[0-100 ng/mL，P=.543]，低Gleason评分组[6-7，P=.266]，低临床T分期组[2-3期，P=.962]，低放射学N分期组[0期，P=.364])。面对当前的趋势，选择细胞减少术的候选人需要慎重考虑，选择标准应该进一步细化，纳入更多的预后因素。(C)2019年爱思唯尔公司。
OBJECTIVE To explore the role of cytoreductive radical prostatectomy (CRP) for locally resectable and distant oligometastatic prostate cancer (CaP).PATIENTS AND METHODS Oligometastases were defined as the presence of 5 or fewer metastatic lesions detected on 99mTc bone scan and no suspicious visceral involvement at pretreatment imaging. Clinical data on 111 consecutive patients who were diagnosed as oligometastatic CaP in our center from 2005 to 2016 was retrospectively collected. In this retrospective cohort study, 35 patients underwent CRP and androgen deprivation therapy, and 76 patients underwent androgen deprivation therapy alone. Oncological outcomes were analyzed by employing Kaplan-Meier method.RESULTS The median follow-up of both groups was 35 months. In whole cohort analyses, prostate-specific antigen (PSA) decrease velocity (P = .167), PSA half-time (P = .263), and PSA nadir (P = .196) were not significantly different between 2 groups. Meanwhile, the differences in oncological outcomes between 2 groups did not reach statistical significance with regard to PSA relapse-free survival (P = .184), clinical progression-free survival (P = .118), and cancer-specific survival (P = .773). In addition, similar results were also observed in prespecified subgroup analyses (lower PSA group [0-100 ng/mL, P = .543], lower Gleason score group [6-7, P = .266], lower clinical T stage group [2-3 stage, P = .962], lower radiological N stage group [0 stage, P = .364]).CONCLUSION In our study, significant benefit from CRP has not been detected in patients with oligometastatic CaP. Facing current trend, it demands deliberate consideration to select candidates for cytoreductive surgery, and the selection criteria should be further refined by incorporating additional prognostic factors. (C) 2019 Elsevier Inc.