Death in patients with recurrent prostate cancer after radical prostatectomy: Prostate-specific antigen doubling time subgroups and their associated contributions to all-cause mortality
Death in patients with recurrent prostate cancer after radical prostatectomy: Prostate-specific antigen doubling time subgroups and their associated contributions to all-cause mortality
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DOI：
10.1200/jco.2006.08.0572
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发表时间：
2007-05-01
影响因子：
45.3
通讯作者：
Partin, Alan W.
中科院分区：
文献类型：
--
作者：
Freedland, Stephen J.;Humphreys, Elizabeth B.;Partin, Alan W.
目的在根治性前列腺切除术后生化复发患者中，我们发现术后前列腺特异性抗原加倍时间（PSADT）与前列腺癌死亡风险相关。然而，考虑到最高风险PSADT亚组的患者数量较少，尚不清楚哪些PSADT亚组对前列腺癌特异性死亡的贡献最大，以及这如何影响全因死亡率。患者和方法本研究回顾性分析了1982年至2000年间379例根治性前列腺切除术患者的生化复发和PSADT数据。术后平均随访时间11.4年（标准差5.4年），中位随访时间11.0年（范围1.6 ~ 23.0年）。结果较短的PSADT与前列腺癌特异性和全因死亡率显著相关（P = 15个月），与前列腺癌相比，竞争原因死亡率风险更大。结论：在根治性前列腺切除术后PSA复发且PSADT少于15个月的年轻健康患者队列中，前列腺癌占复发后15年所有死亡人数的90%。大多数前列腺癌死亡发生在中度PSADT患者中（3.0至8.9个月）。
PurposeAmong patients with biochemical recurrence after radical prostatectomy, we found previously that postoperative prostate-specific antigen doubling time (PSADT) was associated with risk of prostate cancer death. However, given the small number of patients in the highest risk PSADT subgroup, it is unclear which PSADT subgroups contribute the greatest to prostate cancer - specific death and how this influences all-cause mortality.Patients and MethodsThis study was a retrospective analysis of 379 patients treated with radical prostatectomy between 1982 and 2000 who had a biochemical recurrence and PSADT data available. Mean and median follow-up after surgery was 11.4 ( standard deviation, 5.4) and 11.0 years, respectively ( range, 1.6 to 23.0 years).ResultsShorter PSADT was significantly associated with prostate cancer - specific and all-cause mortality ( P = 15 months) had a greater risk of competing-causes mortality compared with that from prostate cancer.ConclusionAmong a select cohort of young, healthy patients with PSA recurrence after radical prostatectomy and a PSADT less than 15 months, prostate cancer accounted for an estimated 90% of all deaths by 15 years after recurrence. The majority of prostate cancer deaths occurred among patients with an intermediate PSADT ( 3.0 to 8.9 months).