Division of Urology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
J Natl Compr Canc Netw. 2010 Feb;8(2):148-54. doi: 10.6004/jnccn.2010.0011.
Prostate cancer can have a long and indolent course, and management without curative therapy should be considered in select patients. When counseling patients, a useful way to convey the risk for death from competing causes is to estimate their lifetime risk for dying from prostate cancer. Double-decrement life tables were constructed to calculate age-specific death rates using the death probabilities from the Social Security Administration life tables and Gleason score-specific mortality rates reported from a pre-PSA cohort study. The lifetime risk for prostate cancer death was calculated. Life tables provided life expectancy and risk for prostate cancer death based on age at diagnosis. For example, a 60-year-old patient with a Gleason score 6, 7, or 8 tumor had an overall life expectancy of 14.4, 10.2, or 6.6 years, respectively. The risk for prostate cancer death during the expected years of life was 33%, 49%, or 57%, respectively. If a 10-year lead-time bias was assumed for PSA detection, the risks for death from prostate cancer decreased to 16%, 26%, or 37%, respectively. If the patient was in the bottom quartile for overall health and disease was detected by prostate examination, the risk for death from prostate cancer was 21%, 32%, or 40%, respectively. A Web-based tool for performing these calculations is available at http://www.roswellpark.org/Patient_Care/Specialized_Services/Prostate_Cancer_Estimator.html. Life tables can be created to estimate overall life expectancy and risk for prostate cancer death, and to assist with decision-making when considering management without curative therapy.
前列腺癌可能具有较长且惰性的病程，在选择患者时，应考虑在没有治愈性治疗的情况下进行管理。在为患者提供咨询时，一种传达因竞争原因死亡风险的有用方法是估计他们死于前列腺癌的终生风险。构建双降生命表是为了使用来自社会保障管理局生命表的死亡概率和来自 PSA 前队列研究的格里森评分特异性死亡率来计算特定年龄的死亡率。计算了死于前列腺癌的终生风险。生命表根据诊断时的年龄提供了预期寿命和死于前列腺癌的风险。例如，一位 60 岁的格里森评分 6、7 或 8 肿瘤患者的总体预期寿命分别为 14.4、10.2 或 6.6 年。在预期寿命期间死于前列腺癌的风险分别为 33%、49%或 57%。如果假设 PSA 检测存在 10 年的领先时间偏差，则死于前列腺癌的风险分别降低至 16%、26%或 37%。如果患者的整体健康状况处于最低四分位数，并且通过前列腺检查发现疾病，则死于前列腺癌的风险分别为 21%、32%或 40%。一个用于执行这些计算的基于网络的工具可在 http://www.roswellpark.org/Patient_Care/Specialized_Services/Prostate_Cancer_Estimator.html 上获得。可以创建生命表来估计总体预期寿命和死于前列腺癌的风险，并在考虑无治愈性治疗的管理时协助决策。
