Cagiannos Ilias, Karakiewicz Pierre, Graefen Markus, Eastham James A, Ohori Makoto, Rabbani Farhang, Reuter Victor, Wheeler Thomas, Kupelian Patrick, Klein Eric, Huland Hartwig, Hammerer Peter G, Erbersdobler Andreas, Schroeder Fritz, Wildhagen Mark, Quinn David I, Henshall Susan M, Grygiel John J, Sutherland Robert L, Stricker Phillip D, Morash Christopher G, Scardino Peter T, Kattan Michael W
Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
J Urol. 2004 Feb;171(2 Pt 1):692-6. doi: 10.1097/01.ju.0000107260.98031.0e.
We examined whether the year in which radical prostatectomy (RP) was performed is a predictor of treatment outcome after controlling for standard prognostic factors.
We examined the association between RP year and outcome in 6,556 patients from 7 centers using preoperative and pathological features. Patients underwent surgery between 1985 and 2000. The variables analyzed were RP year, clinical stage, pretreatment prostate specific antigen, biopsy Gleason sum, RP Gleason sum, margin status, level of extracapsular extension, seminal vesicle status, lymph node status, neoadjuvant hormones and adjuvant therapy. Median followup was 23 months (maximum 166). Separate Cox multivariate regression analyses were performed to analyze preoperative and postoperative factors.
RP year was a predictor of outcome on preoperative analysis (p = 0.006) but not on postoperative analysis (p = 0.130). Patient outcome steadily improved with surgery through the mid 1990s and then it appeared to level off.
When controlling for preoperative features, the year in which RP was performed is a predictor of outcome on multivariate analysis. This effect could not be explained by stage migration.
我们研究了在控制标准预后因素后，进行根治性前列腺切除术（RP）的年份是否为治疗结果的预测指标。
我们利用术前和病理特征，研究了来自7个中心的6556例患者的RP年份与结果之间的关联。患者于1985年至2000年接受手术。分析的变量包括RP年份、临床分期、术前前列腺特异性抗原、活检Gleason评分、RP Gleason评分、切缘状态、包膜外侵犯程度、精囊状态、淋巴结状态、新辅助激素治疗和辅助治疗。中位随访时间为23个月（最长166个月）。进行了单独的Cox多因素回归分析以分析术前和术后因素。
在术前分析中，RP年份是结果的预测指标（p = 0.006），但在术后分析中不是（p = 0.130）。到20世纪90年代中期，患者的手术结果稳步改善，然后似乎趋于平稳。
在控制术前特征时，进行RP的年份是多因素分析中结果的预测指标。这种效应无法用分期迁移来解释。
