[晚期转移性去势抵抗性前列腺癌的生存分析]
[The survival analysis of the advanced metastatic castration-resistant prostate cancer].
作者信息
Ma Chun-guang, Ye Ding-wei, Yao Xu-dong, Zhang Shi-lin, Dai Bo, Zhang Hai-liang, Zhu Yao, Shen Yi-jun, Zhu Yi-ping, Shi Guo-hai, Qin Xiao-jian, Lin Guo-wen, Yang Li-feng, Yang Bo-shuai, Xiao Wen-jun
机构信息
Department of Urology, Cancer Hospital, Fudan University, Shanghai 200032, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2009 Nov 15;47(22):1712-4.
OBJECTIVE
To analyze predictive factors of advanced metastatic castration-resistant prostate cancer.
METHODS
From December 1996 to March 2008, 250 cases of advanced metastatic prostate cancer progressed into the stage of hormonal independent prostate cancer. The last follow-up date was 31 March 2008 and the median follow-up time was 24 months. During the follow-up, 131 cases were alive, 105 cases were dead and 14 cases were lost to follow-up. Clinical and pathological information of the cases was analyzed to find the predictive factors that related to the prognosis.
RESULTS
The median survival time of advanced metastatic castration-resistant prostate cancer was 30 months, and the one-year, two-year, three-year survival rate was 79%, 59%, and 41%. The univariate analysis indicated that prostate specific antigen (PSA) at diagnosis, clinical stage, the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, the time of response duration during hormonal therapy, PSA velocity (PSAV) and PSA doubling time (PSADT) at the emergency of castration-resistant prostate cancer, age and PSA at the diagnosis of castration-resistant prostate cancer were factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer, the time of response duration during hormonal therapy were independent factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer.
CONCLUSION
The PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer and the time of response duration during hormonal therapy are independent factors that predict the survival time of advanced metastatic castration-resistant prostate cancer.
目的
分析晚期转移性去势抵抗性前列腺癌的预测因素。
方法
1996年12月至2008年3月，250例晚期转移性前列腺癌进展至激素非依赖性前列腺癌阶段。最后随访日期为2008年3月31日，中位随访时间为24个月。随访期间，131例存活，105例死亡，14例失访。分析病例的临床和病理信息，以寻找与预后相关的预测因素。
结果
晚期转移性去势抵抗性前列腺癌的中位生存时间为30个月，1年、2年、3年生存率分别为79%、59%和41%。单因素分析表明，诊断时的前列腺特异性抗原（PSA）、临床分期、激素治疗期间的PSA最低点、从激素治疗开始至PSA最低点的时间、激素治疗期间的反应持续时间、去势抵抗性前列腺癌出现时的PSA速度（PSAV）和PSA加倍时间（PSADT）、去势抵抗性前列腺癌诊断时的年龄和PSA是预测晚期转移性去势抵抗性前列腺癌生存时间的因素。多因素分析表明，激素治疗期间的PSA最低点、从激素治疗开始至PSA最低点的时间、去势抵抗性前列腺癌出现时的PSAV、激素治疗期间的反应持续时间是预测晚期转移性去势抵抗性前列腺癌生存时间的独立因素。
结论
激素治疗期间的PSA最低点、从激素治疗开始至PSA最低点的时间、去势抵抗性前列腺癌出现时的PSAV和激素治疗期间的反应持续时间是预测晚期转移性去势抵抗性前列腺癌生存时间的独立因素。
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