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2006年前列腺癌结局研究数据库的最新情况

Update on outcomes research databases in prostate cancer 2006.

作者信息

Freedland Stephen J, Krupski Tracey L, Moul Judd W

机构信息

Department of Surgery, Division of Urology, Duke University School of Medicine, Durham, NC 27710, USA.

出版信息

Curr Opin Urol. 2006 May;16(3):168-72. doi: 10.1097/01.mou.0000193394.62221.e9.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to summarize single-institution prostate-cancer-outcomes databases (which are most commonly derived from large academic medical centers, Veterans Affairs medical centers, and military hospitals) to summarize the design and development of three well characterized outcomes databases that combine data from multiple sites (Carcinoma of the Prostate Strategic Urological Research Endeavor, Center for Prostate Disease Research, and the Shared Equal Access Regional Cancer Hospital database) and to use the examples of obesity and prostate-specific antigen changes over time to highlight the importance of these databases in prostate-cancer outcomes.

RECENT FINDINGS

Multiple databases have demonstrated that obese men are at greater risk of biochemical progression following radical prostatectomy. In addition, objective data have shown that it is more difficult to operate on obese men leading to greater risk of positive surgical margins, which may contribute to poorer outcomes. Several databases have shown that a rapidly increasing prostate-specific antigen, measured either before diagnosis or after failed primary therapy, is associated with increased risk of prostate-cancer-specific mortality.

SUMMARY

Outcomes databases are extremely useful tools. They have lead to dramatic improvements of our understanding of prostate cancer. The challenge is to use this information from past patients to help us better manage our current and future patients.

摘要

综述目的

本综述旨在总结单机构前列腺癌结局数据库(其大多源自大型学术医疗中心、退伍军人事务医疗中心及军事医院),概述三个特征明确的结局数据库的设计与开发,这些数据库整合了来自多个机构的数据(前列腺癌战略泌尿学研究计划、前列腺疾病研究中心及共享平等获取区域癌症医院数据库),并以肥胖及前列腺特异性抗原随时间变化为例,强调这些数据库在前列腺癌结局研究中的重要性。

最新发现

多个数据库已证实,肥胖男性在根治性前列腺切除术后发生生化进展的风险更高。此外,客观数据表明,对肥胖男性进行手术难度更大,导致手术切缘阳性风险更高,这可能导致预后更差。多个数据库显示,在诊断前或初始治疗失败后测得的前列腺特异性抗原快速升高,与前列腺癌特异性死亡风险增加相关。

总结

结局数据库是极为有用的工具。它们极大地增进了我们对前列腺癌的理解。挑战在于利用过去患者的这些信息来帮助我们更好地管理当前及未来的患者。

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