The association of tumor volume with mortality following radical prostatectomy
The association of tumor volume with mortality following radical prostatectomy
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DOI：
10.1038/pcan.2013.61
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发表时间：
2014-06-01
影响因子：
4.8
通讯作者：
Boorjian, S. A.
中科院分区：
文献类型：
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作者：
Knoedler, J. J.;Karnes, R. J.;Boorjian, S. A.
背景：关于前列腺癌肿瘤体积（TV）的预后意义的数据是相互矛盾的。在此，我们评估了根治性前列腺切除术（RP）后的TV与前列腺癌死亡率的相关性，并评估了TV对已建立的预测模型的附加预后价值。方法：我们确定了1987年至2009年期间未经术前治疗的13 687例RP患者。TV使用长椭球公式估计。使用Kaplan-Meier方法估计生存率，并与对数秩检验进行比较。采用考克斯比例风险回归模型评价TV与死亡率的相关性。TV增强已建立的预后模型（马约诊所GPSM（Gleason、PSA、精囊和边缘状态）评分）性能的能力使用c指数进行评估。TV增加与精囊侵犯的风险显著增加相关（危险比（HR）1.58; P
BACKGROUND: Data regarding the prognostic significance of tumor volume (TV) in prostate cancer are conflicting. Herein, we evaluated the association of TV with prostate cancer mortality following radical prostatectomy (RP), and assessed the additive prognostic value of TV to an established predictive model.METHODS: We identified 13 687 patients who underwent RP without preoperative therapy between 1987 and 2009. TV was estimated using the prolate ellipsoid formula. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of TV with mortality. The ability of TV to enhance the performance of an established prognostic model (Mayo Clinic GPSM (Gleason, PSA, seminal vesicle and margin status) score) was assessed using the c-index.RESULTS: Median TV was 1.57 cm(3) (interquartile range (IQR) 0.48-4.19). Increasing TV was associated with significantly higher risks of seminal vesicle invasion (hazard ratio (HR) 1.58; P