Prostate cancer-specific mortality burden by risk group among men with localized disease: Implications for research and clinical trial priorities.
Prostate cancer-specific mortality burden by risk group among men with localized disease: Implications for research and clinical trial priorities.
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患有局部疾病的男性中按风险组划分的前列腺癌特异性死亡率负担：对研究和临床试验优先事项的影响。
DOI：
10.1002/pros.24041
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Muralidhar,Vinayak
中科院分区：
文献类型：
--
作者：
Dee,EdwardChristopher;Nezolosky,MichelleD;Chipidza,FallonE;Arega,MelakuA;Butler,SantinoS;Sha,SybilT;Mahal,BrandonA;Nguyen,PaulL;Yang,DavidD;Muralidhar,Vinayak
目的评估每个N0M0前列腺癌风险组的前列腺癌特异性死亡率（PCSM）相对负担的当代基于人群的模式，这可能指导研究、试验设计和临床实践的优先排序。方法我们将2004 - 2015年监测、流行病学和最终结果数据库中的患者按风险组（低风险、中等风险、中等风险、高风险和非常高风险）进行分类。使用Fine - Gray方法，我们计算了每个风险组10年PCSM的相对负担。结果samongn = 337162名男性（中位随访6.8年，中位年龄65岁），低、中、中、高、极高危诊断相对比例分别为29.9% （N= 100 969）、31.1% （N= 104 696）、17.9% （N= 60 360）、18.1% （N= 61 023）、3.0% （N= 10 114）。在诊断后10年内，死于前列腺癌的患者（N= 15064）中，5.0% （N= 746）为低危，13.7% （N= 2060）为中危，16.1% （N= 2429）为中危，47.8% （N= 7196）为高危，17.5% （N= 2633）为非常高危。65岁及以上的患者占所有诊断的51.9%，占10年PCSM的72.3%。尽管黑人患者占低风险诊断的15.0%，但他们占10年PCSM的20.6%。白人患者占低风险诊断的80.3%，占10年PCSM的75.7%。结论虽然高风险和极高风险疾病占诊断的五分之一，但它们占10年PCSM的三分之二。老年患者和患有低风险疾病的黑人患者占死亡人数的不成比例的很大比例。这些发现支持针对高风险疾病的针对性研究，并确保老年和黑人男性在临床试验中的充分代表性。
ObjectiveTo estimate contemporary population‐based patterns of the relative burden of prostate cancer‐specific mortality (PCSM) attributable to each N0M0 prostate cancer risk‐group, that may guide prioritization in research, trial design, and clinical practice.MethodsWe categorized 2004‐2015 Surveillance, Epidemiology, and End Results database patients by risk group (low, favorable intermediate, unfavorable intermediate, high, and very highrisk). Using the Fine‐Gray method, we calculated the relative burden of 10‐year PCSM attributable to each risk group.ResultsAmongN= 337 162 men (6.8‐year median follow‐up; median age 65 years), the relative proportion of low‐, favorable intermediate‐, unfavorable intermediate‐, high‐, and very high‐risk diagnoses were 29.9% (N= 100 969), 31.1% (N= 104 696), 17.9% (N= 60 360), 18.1% (N= 61 023), and 3.0% (N= 10 114). Within 10 years of diagnosis, among patients who died of prostate cancer (N= 15 064), 5.0% (N= 746) had low‐risk, 13.7% (N= 2060) had favorable intermediate‐risk, 16.1% (N= 2429) had unfavorable intermediate‐risk, 47.8% (N= 7196) had high‐risk, and 17.5% (N= 2633) had very high‐risk disease at diagnosis. Patients aged 65 and older accounted for 51.9% of all diagnoses and 72.3% of 10‐year PCSM. Although black patients accounted for 15.0% of low‐risk diagnoses, they accounted for 20.6% of 10‐year PCSM. White patients accounted for 80.3% of low‐risk diagnoses and 75.7% of 10‐year PCSM.ConclusionAlthough high‐risk and very high‐risk disease account for one‐fifth of diagnoses, they account for two‐thirds of 10‐year PCSM. Older patients and black patients with low‐risk disease accounted for a disproportionately large proportion of deaths. These findings support targeting research toward high‐risk disease and ensuring adequate representation of older and black men in clinical trials.
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影响因子：
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