Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era
Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era
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DOI：
10.1200/jco.2003.01.075
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发表时间：
2003-06-01
影响因子：
45.3
通讯作者：
Chen, MH
中科院分区：
文献类型：
--
作者：
D'Amico, AV;Moul, J;Chen, MH
研究对象和方法：1988年至2002年，在美国44家机构接受手术(4,946例)或放疗(2,370例)治疗的前列腺癌患者组成了研究队列，研究对象为T1c-2、N0或Nx、M0期前列腺癌。用COX回归分析来确定治疗前危险组预测治疗后PCSM时间的能力。结果：前列腺特异性抗原(PSA)失败8年后非PCSM的估计分别为4%比15%(手术和放疗；P-log等级=0.002)，而PSA失败时年龄小于70岁的患者的13%比18%(手术和放疗；P-log等级=.35)。手术管理的高危和中危患者治疗后PCSM的RR分别为14.2(95%CI，5.0~23.4；P-COX和lt；0.0001)和4.9(95%CI，1.7~8.1；P-COX=0.0037)。这些数值分别为14.3(95%CI，5.2~24.0；P-COX和lt；0.0001)和5.6(95%CI，2.0~9.3；P-COX=0.0012)。结论：本研究为PSA治疗的临床局限性前列腺癌患者手术或放疗后PCSM时间的预测提供了证据。(C)2003年，由美国临床肿瘤学会提供。
Purpose: To determine whether pretreatment risk groups shown to predict time to prostate cancer-specific mortality (PCSM) after treatment at a single institution retained that ability in a multi-institutional setting.Patients and Methods: From 1988 to 2002, 7,316 patients treated in the United States at 44 institutions with either surgery (n = 4,946) or radiation (n = 2,370) for clinical stage T1c-2, N0 or NX, M0 prostate cancer made up the study cohort. A Cox regression analysis was performed to determine the ability of pretreatment risk groups to predict time to PCSM after treatment. The relative risk (RR) of PCSM and 95% confidence intervals (CIs) were calculated for the intermediate- and high-risk groups relative to the low-risk group.Results: Estimates of non-PCSM 8 years after prostate-specific antigen (PSA) failure were 4% v 15% (surgery versus radiation; P-log rank = .002) compared with 13% v 18% (surgery versus radiation; P-log rank = .35) for patients whose age at the time of PSA failure was less than 70 as compared with !: 70 years, respectively. The RR of PCSM after treatment for surgery-managed patients with high- or intermediate-risk disease was 14.2 (95% CI, 5.0 to 23.4; P-Cox < .0001) and 4.9 (95% CI, 1.7 to 8.1; P-Cox = .0037), respectively. These values were 14.3 (95% CI, 5.2 to 24.0; P-Cox < .0001) and 5.6 (95% CI, 2.0 to 9.3; P-Cox = .0012) for radiation-managed patients.Conclusion: This study provided evidence to support the prediction of time to PCSM after surgery or radiation on the basis of pretreatment risk groups for patients with clinically localized prostate cancer managed during the PSA era. (C) 2003 by American Society of Clinical Oncology.