Clinical outcome of Taiwanese men with clinically localized prostate cancer post-radical prostatectomy: a comparison with other ethnic groups
Clinical outcome of Taiwanese men with clinically localized prostate cancer post-radical prostatectomy: a comparison with other ethnic groups
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DOI：
10.3109/13685530903294370
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发表时间：
2010-03-01
期刊：
影响因子：
2.6
通讯作者：
Wu, Wen-Jeng
中科院分区：
文献类型：
--
作者：
Huang, Shu-Pin;Huang, Chao-Yuan;Wu, Wen-Jeng
背景前列腺癌的发病率在不同的种族群体之间差异很大。然而，关于低发病率亚洲人群根治性直肠癌切除术（RP）后的临床结局的报告仍然有限。我们的目的是比较不同种族的RP治疗患者的临床结果，并确定台湾患者的重要预后因素。本研究共纳入341例在台湾三个医学中心接受根治性RP的临床局限性前列腺癌患者。使用来自美国（US）和一个大型欧洲系列的CaPSURE、EQUIPMENT数据库进行种族组比较。采用Kaplan-Meier分析和考克斯比例风险模型分析前列腺特异性抗原（PSA）复发的显著性预测因素。与美国和欧洲研究中的白人白色人群相比，中国台湾人群的手术年龄更高，术前PSA水平更高。平均和中位随访时间为39.1个月和31.0个月（范围5-120个月），127名男性（37.2%）PSA复发，显著高于西方系列。在术后总体模型中确定的PSA复发的重要预测因素是PSA水平、病理Gleason评分、病理肿瘤分期和淋巴结转移。台湾男性前列腺癌RP后的临床结果似乎不如西方国家，这在很大程度上是由于在较高的PSA水平下延迟手术。早期诊断和治疗可提高RP的控制率。
Background. Prostate cancer incidence varies significantly among different ethnic groups. However, the report concerning the clinical outcome after radical prostatectomy ( RP) in the low incidence Asian population is still limited. We aimed to compare the clinical outcome in patient treated with RP among different ethnic groups and to identify significant prognostic factors in Taiwanese patients.Methods. A total of 341 patients with clinical localized prostate cancer undergoing curative RP in three medical centers in Taiwan were included in this study. Ethnic group comparison was performed using the CaPSURE, SEARCH databases from United States ( US) and one large European series. The Kaplan-Meier analysis and Cox proportional hazard model were used to identify significant predictors for prostate-specific antigen (PSA) recurrence.Results. Compared to the Caucasian white population in the US and Europe studies, the Taiwanese population have higher age at surgery and higher pre-operative PSA level. With mean and median follow-up of 39.1 months and 31.0 months ( range 5-120 months), 127 men (37.2%) had PSA recurrence which was significant higher than the Western series. Significant predictors for PSA recurrence identified in the post-operative overall model were PSA level, pathological Gleason Score, pathological tumor stage and lymph node metastasis.Conclusions. The clinical outcome of Taiwanese male with prostate cancer post-RP appears inferior to the Western country, which is largely due to delay surgery at higher PSA level. Earlier diagnosis and treatment may improve the cancer control of RP.