Mucinous Prostate Cancer Shows Similar Prognosis to Typical Prostate Acinar Carcinoma: A Large Population-Based and Propensity Score-Matched Study
Mucinous Prostate Cancer Shows Similar Prognosis to Typical Prostate Acinar Carcinoma: A Large Population-Based and Propensity Score-Matched Study
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粘液性前列腺癌与典型前列腺腺泡癌的预后相似：一项基于人群的倾向评分匹配研究
DOI：
10.3389/fonc.2019.01467
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发表时间：
2020-01-09
影响因子：
4.7
通讯作者：
Yan, Senxiang
中科院分区：
文献类型：
--
作者：
Zhao, Feng;Yu, Xiaokai;Yan, Senxiang
背景：黏液性前列腺癌是一种极为罕见的前列腺恶性肿瘤。迄今为止，对其生物学和结果的有限了解大多来自小型单一机构的经验。我们分析了监测、流行病学和最终结果（SEER）数据库，以探讨黏液性前列腺癌的发病率和治疗及其预后因素，以获得相对较大和综合的见解。方法：随时间推移评估年龄调整发生率（AAI）。采用倾向评分匹配（PSM）和Kaplan-Meier分析比较黏液性前列腺癌与典型前列腺腺泡腺癌的预后。我们根据总结分期和治疗选择评估患者分层后的癌症特异性生存期（CSS）和总生存期（OS）。采用Cox风险回归分析确定CSS和OS的独立预测因子。结果：2016年AAI为0.24 /百万。黏液性前列腺癌患者的CSS和OS与典型前列腺腺泡腺癌患者相似。在治疗方面，65.3%的黏液性PCa患者接受手术治疗，23.9%的患者接受放射治疗。接受手术的患者生存时间更长（CSS, p = 0.012； OS, p < 0.001），接受放疗的患者与未接受放疗的患者生存时间相似（CSS, p = 0.794； OS, p = 0.097）。CSS和OS的多因素Cox分析显示，年龄（CSS: HR: 4.982, p = 0.001; OS: HR: 4.258, p < 0.001）和远期分期（CSS: HR: 40.224, p < 0.001; OS: HR: 9.866, p < 0.001）是黏液性PCa患者的独立预后因素。结论：黏液性PCa具有极低的AAI。对其结果的分析表明，它并不像以前怀疑的那样是一种更恶性的肿瘤。黏液性前列腺癌的预后与典型的前列腺腺泡癌相似。手术与延长生存期有关。诊断时年龄越大，分期越远，生存率越低。
Background: Mucinous prostate cancer (PCa) is an extremely rare form of prostate malignancy. To date, the limited knowledge of its biology and outcomes stems from mostly small, single institution experiences. We analyzed the Surveillance, Epidemiology, and End Results (SEER) database to explore the incidence and treatment of mucinous PCa together with its prognostic factors to gain relatively large and consolidated insights. Methods: Age-adjusted incidence (AAI) rates were evaluated over time. Propensity score matching (PSM) and Kaplan–Meier analyses were used to compare the prognosis between mucinous PCa and typical prostate acinar adenocarcinoma. We assessed cancer-specific survival (CSS) and overall survival (OS) after patient stratification according to summary stage and treatment choice. Cox hazards regression analysis was performed to determine independent predictors of CSS and OS. Results: The AAI in 2016 was 0.24 per million. Patients with mucinous PCa had similar CSS and OS to matched individuals with typical prostate acinar adenocarcinoma. In terms of treatment, 65.3% of mucinous PCa patients underwent surgery, and 23.9% received radiation therapy. Patients who underwent surgery had longer survival (CSS, p = 0.012; OS, p < 0.001), and patients who received radiation therapy had similar survival to those who did not receive radiation therapy (CSS, p = 0.794; OS, p = 0.097). A multivariate Cox analysis for CSS and OS showed that older age (CSS: HR: 4.982, p = 0.001; OS: HR: 4.258, p < 0.001) and distant stage (CSS: HR: 40.224, p < 0.001; OS: HR: 9.866, p < 0.001) were independent prognostic factors for mucinous PCa patients. Conclusions: Mucinous PCa has an extremely low AAI. Analysis of its outcomes indicates that it is not a more malignant tumor as previously suspected. Mucinous PCa shows a similar prognosis to typical prostate acinar carcinoma. Surgery was associated with prolonged survival. An older age at diagnosis and distant stage was associated with poor survival.