Impact of Adjuvant Radiotherapy on Survival of Patients With Node-Positive Prostate Cancer
Impact of Adjuvant Radiotherapy on Survival of Patients With Node-Positive Prostate Cancer
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DOI：
10.1200/jco.2013.54.7893
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发表时间：
2014-12-10
影响因子：
45.3
通讯作者：
Briganti, Alberto
中科院分区：
文献类型：
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作者：
Abdollah, Firas;Karnes, R. Jeffrey;Briganti, Alberto
目的辅助放疗（aRT）在pN 1前列腺癌治疗中的作用存在争议。我们测试的假设，aRT对癌症特异性死亡率（CSM）在这些人的影响是相关的肿瘤characteristics.MethodsWe评估了1,107例pN 1前列腺癌根治性切除术和解剖学扩展盆腔淋巴结清扫术在1988年和2010年之间在两个三级保健中心。所有患者均接受辅助激素治疗，有或无aRT。回归树分析根据肿瘤特征和相应的CSM率将患者分为风险组。考克斯回归分析测试aRT和CSM率之间的关系，以及总死亡率（OM）率在每个风险groups.ResultsOverall，35%的患者接受aRT. At多变量分析，aRT与更有利的CSM率（风险比[HR]，0.37; P <0.001）。然而，当患者被分为风险组时，只有两组男性受益于aRT：（1）淋巴结（PLN）计数阳性的患者
PurposeThe role of adjuvant radiotherapy (aRT) in treating patients with pN1 prostate cancer is controversial. We tested the hypothesis that the impact of aRT on cancer-specific mortality (CSM) in these individuals is related to tumor characteristics.MethodsWe evaluated 1,107 patients with pN1 prostate cancer treated with radical prostatectomy and anatomically extended pelvic lymph node dissection between 1988 and 2010 at two tertiary care centers. All patients received adjuvant hormonal therapy with or without aRT. Regression tree analysis stratified patients into risk groups on the basis of their tumor characteristics and the corresponding CSM rate. Cox regression analysis tested the relationship between aRT and CSM rate, as well as overall mortality (OM) rate in each risk group separately.ResultsOverall, 35% of patients received aRT. At multivariable analysis, aRT was associated with more favorable CSM rate (hazard ratio [HR], 0.37; P < .001). However, when patients were stratified into risk groups, only two groups of men benefited from aRT: (1) patients with positive lymph node (PLN) count