Long-term outcomes after radical prostatectomy performed in a community-based health maintenance organization.
Long-term outcomes after radical prostatectomy performed in a community-based health maintenance organization.
复制标题
在社区健康维护组织中进行根治性前列腺切除术后的长期结果。
DOI：
10.1002/cncr.11886
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
Gelmann,EdwardP
中科院分区：
文献类型：
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作者：
Zhang,Ying;Glass,Andrew;Bennett,Nicole;Oyama,KarenA;Gehan,Edmund;Gelmann,EdwardP
背景：根治性前列腺切除术被广泛用于治疗局限性前列腺癌。在社区健康维护组织中进行的一系列根治性前列腺切除术没有长期分析报道。方法回顾1970年至1996年间在社区健康维护组织接受根治性前列腺切除术的750例患者的图表和组织学切片。分析了一些变量对无进展生存期（PFS）和总生存期（OS）的影响。结果幸存者中位随访时间为6.2年，137例（18%）患者病情进展，149例（20%）患者死于各种原因。自诊断之日起的中位生存期为15.7年（95%可信区间为13.6-17.2），与预期的中位生存期16.2年相似。诊断后的中位PFS未达到，但75%的患者在接受前列腺切除术后≥10.6年无进展。预后因素包括Gleason评分、诊断年龄和T分期。结果与基于大学实践的外科系列报告相当。结论Gleason评分≤6分、T1或T2肿瘤状态、诊断年龄较轻是与生存相关的重要且有利的患者特征。诊断时较低的前列腺特异性抗原值以及前两个参数也与PFS有良好的相关性。在以社区为基础的健康维护组织进行根治性前列腺切除术后，长期PFS和OS与以大学为基础的实践报告的结果相当。根治性前列腺切除术对生存率的影响仍有待证实。癌症2004;100:300-7。©2003美国癌症协会。
BACKGROUNDRadical prostatectomy is used widely for the treatment of patients with localized prostate carcinoma. No long‐term analysis has been reported on a series of radical prostatectomies performed in a community‐based health maintenance organization.METHODSCharts and histologic slides were reviewed from 750 patients who underwent radical prostatectomy between 1970 and 1996 at a community‐based health maintenance organization. The influences of a number of variables were analyzed for their impact on progression free survival (PFS) and overall survival (OS).RESULTSWith a median follow‐up of 6.2 years among survivors, 137 patients (18%) had progressive disease, and 149 patients (20%) died from all causes. The median OS from the date of diagnosis was 15.7 years (95% confidence interval, 13.6–17.2), similar to the expected median survival of 16.2 years. The median PFS from diagnosis was not reached, but 75% of patients were progression free ≥ 10.6 years after undergoing prostatectomy. The prognostic factors included Gleason score, age at diagnosis, and T stage. Outcomes were comparable with reports of surgical series from university‐based practices.CONCLUSIONSThe patient characteristics that had important, favorable correlation with survival included Gleason score ≤ 6, T1 or T2 tumor status, and younger age at diagnosis. Lower prostate‐specific antigen values at diagnosis, together with the former two parameters, also had a favorable correlation with PFS. Radical prostatectomy in a community‐based health maintenance organization was followed by long‐term PFS and OS comparable to outcomes reported from university‐based practices. The impact of radical prostatectomy on survival remains to be demonstrated. Cancer 2004;100:300–7. © 2003 American Cancer Society.