[转移性前列腺癌的生存分析]

[The survival analysis of metastatic 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, Xiao Wen-Jun, Yang Li-Feng, Yang Bo-Shuai, Cao Da-Long

机构信息

Department of Urology, Cancer Hospital, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2010 Aug 1;48(15):1166-9.

PMID:21055012

Abstract

OBJECTIVES

To analyze the clinical and pathological informations of metastatic prostate cancer patients to find the predictive factors of the survival.

METHODS

To filter 364 cases of metastatic prostate cancer in the 940 cases of prostate cancer that were treated in Cancer Hospital Fudan University in Shanghai from March 1998 to June 2009, the cases had hormonal therapy and full clinical and pathological records. All the 364 cases were followed up and the clinical and pathological informations were analyzed, to find the predictive factors that related to the prognosis. Statistic software SPSS 15.0 was used for analysis. Cumulative survival was analyzed by the method of Kaplan-Meier. Cox regression was used for univariate and multivariate analysis. Log-rank method was used for the significance test.

RESULTS

The last follow-up date was 30th June 2009 and the median follow-up time was 24 months. At the final follow-up, 240 cases were alive, 109 cases were dead and 15 cases were lost to follow up. The median survival time of metastatic prostate cancer was 64 months, and the one-year, two-year, three-year, four-year, five-year survival rate was 92%, 78%, 66%, 60%, 54%. The univariate analysis indicated that Gleason score (P = 0.033), clinical stage (P < 0.001), the effectiveness of hormonal therapy (P < 0.001), the prostate specific antigen (PSA) nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P = 0.002) were predictive factors for the survival time of metastatic prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P < 0.001) were independent factors that predict the survival time of metastatic prostate cancer.

CONCLUSION

The PSA nadir during hormonal therapy and the time from the start of hormonal therapy to the PSA nadir are independent factors that predict the survival time of metastatic prostate cancer.

摘要

目的

分析转移性前列腺癌患者的临床及病理信息，寻找生存的预测因素。

方法

从1998年3月至2009年6月在上海复旦大学附属肿瘤医院接受治疗的940例前列腺癌患者中筛选出364例转移性前列腺癌患者，这些患者均接受过激素治疗且有完整的临床及病理记录。对这364例患者进行随访并分析其临床及病理信息，以寻找与预后相关的预测因素。采用统计软件SPSS 15.0进行分析。采用Kaplan-Meier法分析累积生存率。采用Cox回归进行单因素和多因素分析。采用Log-rank法进行显著性检验。

结果

最后随访日期为2009年6月30日，中位随访时间为24个月。末次随访时，240例患者存活，109例患者死亡，15例患者失访。转移性前列腺癌的中位生存时间为64个月，1年、2年、3年、4年、5年生存率分别为92%、78%、66%、60%、54%。单因素分析表明， Gleason评分（P = 0.033）、临床分期（P < 0.001）、激素治疗效果（P < 0.001）、激素治疗期间前列腺特异性抗原（PSA）最低点（P < 0.001）以及从激素治疗开始至PSA最低点的时间（P = 0.002）是转移性前列腺癌生存时间的预测因素。多因素分析表明，激素治疗期间的PSA最低点（P < 0.001）以及从激素治疗开始至PSA最低点的时间（P < 0.001）是预测转移性前列腺癌生存时间的独立因素。