Balaji K C, Rabbani F, Tsai H, Bastar A, Fair W R
Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
J Urol. 1999 Sep;162(3 Pt 1):753-7. doi: 10.1097/00005392-199909010-00035.
We studied the effect of neoadjuvant hormonal therapy on prostatic intraepithelial neoplasia in patients undergoing radical prostatectomy and assessed the effect of prostatic intraepithelial neoplasia on disease recurrence as measured by serum prostate specific antigen (PSA).
A total of 278 patients with clinically localized prostate cancer were included in phase II and III studies evaluating radical prostatectomy alone versus radical prostatectomy following neoadjuvant hormonal therapy at Memorial Sloan-Kettering Cancer Center between October 1991 and August 1996. Patient data related to prostatic intraepithelial neoplasia were analyzed.
Of 275 evaluable patients 145 (52.7%) had prostatic intraepithelial neoplasia. Of 50 patients treated with neoadjuvant hormonal therapy (hormone group) 22 (44%) had a lower incidence of prostatic intraepithelial neoplasia compared to 69 of 80 controls (86.3%) (chi-square test p<0.0001). Of 262 patients (95.3%) with followup PSA 44 (16.8%) had PSA recurrence at a median followup of 32 months, with a median time to recurrence of 30 months. PSA recurrence was noted in 23 of 145 patients with compared to 21 of 130 without prostatic intraepithelial neoplasia (chi-square test p = 0.95), and did not significantly differ between the hormone group (25 of 142, 17.6%) and controls (19 of 130, 14.6%) (chi-square test p = 0.45).
While patients treated with neoadjuvant hormonal therapy had significantly lower incidence of prostatic intraepithelial neoplasia, neither prostatic intraepithelial neoplasia nor neoadjuvant hormonal therapy significantly affected PSA recurrence at a median followup of 32 months.
我们研究了新辅助激素治疗对接受根治性前列腺切除术患者前列腺上皮内瘤变的影响，并评估了前列腺上皮内瘤变对血清前列腺特异性抗原（PSA）测定的疾病复发的影响。
1991年10月至1996年8月期间，纪念斯隆凯特琳癌症中心共有278例临床局限性前列腺癌患者纳入了II期和III期研究，评估单纯根治性前列腺切除术与新辅助激素治疗后根治性前列腺切除术的疗效。分析了与前列腺上皮内瘤变相关的患者数据。
在275例可评估患者中，145例（52.7%）有前列腺上皮内瘤变。在接受新辅助激素治疗的50例患者（激素组）中，22例（44%）前列腺上皮内瘤变的发生率低于80例对照组中的69例（86.3%）（卡方检验p<0.0001）。在262例（95.3%）有PSA随访的患者中，44例（16.8%）在中位随访32个月时出现PSA复发，中位复发时间为30个月。145例有前列腺上皮内瘤变的患者中有23例出现PSA复发，而130例无前列腺上皮内瘤变的患者中有21例出现PSA复发（卡方检验p = 0.95），激素组（14个中的25个，17.6%）和对照组（130个中的19个，1次4.6%）之间无显著差异（卡方检验p = 0.45）。
虽然接受新辅助激素治疗的患者前列腺上皮内瘤变的发生率显著较低，但在中位随访32个月时，前列腺上皮内瘤变和新辅助激素治疗均未显著影响PSA复发。
