局部前列腺癌患者放疗后，阳性前列腺活检百分比在预测前列腺癌特异性生存和总生存方面的临床效用。

Clinical utility of the percentage of positive prostate biopsies in predicting prostate cancer-specific and overall survival after radiotherapy for patients with localized prostate cancer.

作者信息

D'Amico Anthony V, Keshaviah Aparna, Manola Judith, Cote Kerri, Loffredo Marian, Iskrzytzky Olga, Renshaw Andrew A

机构信息

Department of Radiation Oncology, Brigham and Women's Hospital, 75 Francis Street, L-2 Level, Boston, MA 02215, USA.

出版信息

Int J Radiat Oncol Biol Phys. 2002 Jul 1;53(3):581-7. doi: 10.1016/s0360-3016(02)02797-9.

DOI:10.1016/s0360-3016(02)02797-9

PMID:12062600

Abstract

PURPOSE

To determine whether the percentage of positive prostate biopsies provides clinically relevant information to a previously established risk stratification system with respect to the end points of prostate cancer-specific survival (PCSS) and overall survival after radiotherapy for patients with clinically localized prostate cancer.

METHODS AND MATERIALS

A Cox regression multivariable analysis was used to evaluate the ability of the percentage of positive prostate biopsies to predict PCSS and overall survival for 381 men who underwent radiotherapy for localized prostate cancer during the prostate-specific antigen era.

RESULTS

At a median follow-up of 4.3 years (range 0.8-13.3), the presence of < or =50% positive biopsies vs. >50% positive biopsies provided a clinically relevant stratification of the 7-year estimates of PCSS (100% vs. 57%, p = 0.004) in intermediate-risk patients. Moreover, all patients could be stratified into a minimal or high-risk cohort on the basis of the 10-year estimates of PCSS (100% vs. 55%, p <0.0001) and overall survival (87% vs. 40%, p = 0.02) by incorporating the percentage of positive prostate biopsy information into a previously established risk stratification system.

CONCLUSION

The clinically relevant stratification of PCSS using the percentage of positive prostate biopsies in intermediate-risk patients confirms previous findings based on prostate-specific antigen outcome. These data provide evidence to support the ability to stratify newly diagnosed patients with clinically localized disease into a minimal-risk (low-risk + low biopsy volume [< or =50%] intermediate-risk) or high-risk (high biopsy volume [>50%] intermediate-risk + high-risk) cohort for prostate cancer-specific death after conventional dose radiotherapy. Additional follow-up and independent validation are needed to confirm these findings.

摘要

目的

确定前列腺穿刺活检阳性率是否能为已建立的风险分层系统提供有关临床局限性前列腺癌患者前列腺癌特异性生存（PCSS）和放疗后总生存终点的临床相关信息。

方法和材料

采用Cox回归多变量分析，评估前列腺穿刺活检阳性率对381例在前列腺特异性抗原时代接受局限性前列腺癌放疗的男性患者的PCSS和总生存的预测能力。

结果

在中位随访4.3年（范围0.8 - 13.3年）时，对于中危患者，穿刺活检阳性率≤50%与＞50%相比，在7年PCSS估计值方面提供了具有临床相关性的分层（100%对57%，p = 0.004）。此外，通过将前列腺穿刺活检阳性率信息纳入先前建立的风险分层系统，所有患者可根据10年PCSS估计值（100%对55%，p <0.0001）和总生存（87%对40%，p = 0.02）分为低危或高危队列。

结论

使用前列腺穿刺活检阳性率对中危患者进行PCSS的临床相关分层证实了基于前列腺特异性抗原结果的先前发现。这些数据为支持将新诊断的临床局限性疾病患者分层为低危（低风险 + 低活检量[≤50%]中危）或高危（高活检量[>50%]中危 + 高风险）队列以预测常规剂量放疗后前列腺癌特异性死亡提供了证据。需要进一步随访和独立验证来证实这些发现。