Maximal tumor diameter and the risk of PSA failure in men with specimen-confined prostate cancer
Maximal tumor diameter and the risk of PSA failure in men with specimen-confined prostate cancer
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DOI：
10.1016/j.urology.2005.05.037
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发表时间：
2005-11-01
期刊：
影响因子：
2.1
通讯作者：
D'Amico, AV
中科院分区：
文献类型：
--
作者：
Dvorak, T;Chen, MH;D'Amico, AV
目标。评估最大肿瘤直径（MTD）是否与术后前列腺特异性抗原（PSA）失败的时间显着相关。方法。 1986 年至 2002 年间，781 名临床 T1c-T2 期前列腺癌男性接受了根治性前列腺切除术。 MTD 记录为所有 3 毫米阶梯切片中最大单个癌症病灶的最大尺寸。中位随访时间为 5.4 年（范围 0.1 至 14.9 年）； 242 名男性 (31%) 经历过 PSA 失败。 Cox 回归分析用于确定术后 PSA 失败时间的预测因素。对 PSA 无失败生存期进行 Kaplan-Meier 估计，根据中位 MTD 值进行二分，并使用双边对数秩检验进行比较。结果。 MTD 值与 PSA 失败时间显着相关（调整后风险比 1.04，95% 置信区间 1.01 至 1.07，P = 0.004），控制术前 PSA 水平 (P < 0.0001)、前列腺切除术 Gleason 评分 (P < 0.0001) 和 T 分期 (P
Objectives. To evaluate whether the maximal tumor diameter (MTD) is significantly associated with the time to postoperative prostate-specific antigen (PSA) failure.Methods. Between 1986 and 2002, 781 men with clinical Stage T1c-T2 prostate cancer underwent radical prostatectomy. The MTD was recorded as the maximal dimension of the largest single focus of cancer from all 3-mm step sections. The median follow-up was 5.4 years (range 0.1 to 14.9); 242 men (31%) experienced PSA failure. A Cox regression analysis was used to determine the predictors of time to postoperative PSA failure. Kaplan-Meier estimates of PSA failure-free survival were made, dichotomized about the median MTD value, and compared using a two-sided log-rank test.Results. The value of the MTD was significantly associated with the time to PSA failure (adjusted hazard ratio 1.04, 95% confidence interval 1.01 to 1.07, P = 0.004), controlling for preoperative PSA level (P < 0.0001), prostatectomy Gleason score (P < 0.0001), and T stage (P