Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California 94143-1695, USA.
J Urol. 2011 Nov;186(5):1825-9. doi: 10.1016/j.juro.2011.06.055. Epub 2011 Sep 25.
We described changes in tumor volume on serial biopsies during an extended period in men on active surveillance.
The study cohort included men diagnosed with prostate cancer between 1998 and 2010 enrolled in active surveillance with 6 or more months of followup. Change in volume over time was assessed as change in percent cores positive, percent cancer in 1 biopsy core and the doubling of total cancer volume (mm). Logistic regression was used to determine the association between grade and volume progression.
A total of 399 men met the study inclusion criteria. Mean patient age was 61.8 years old and 313 (78%) had low risk disease. Overall 231 (58%) men had stable disease on repeat biopsies. There were 39 (10%) men with a volume increase, defined by an increase to more than 33% cores involved or an increase in maximum single core positive to more than 50%, and there were 44 (11%) with an increase in volume and grade. Approximately 10% of men experienced a decrease in cancer volume. On multivariate analysis there was a significant association between grade and volume progression on any biopsy (OR 3.07), and a doubling of tumor length (mm) at 5 years (OR 6.30).
Prostate cancer volume increases and decreases at a similar rate of 10% per biopsy. An increase in tumor volume is associated with an increase in cancer grade on early repeat biopsies. However, there is a large degree of variation in cancer volume over time.
我们描述了在主动监测期间对男性进行多次活检时肿瘤体积的变化。
研究队列包括 1998 年至 2010 年间被诊断患有前列腺癌并接受主动监测且随访时间超过 6 个月的男性。通过改变核心阳性百分比、单次活检核心中的癌症百分比和总癌症体积（mm）的两倍来评估随时间变化的体积变化。使用逻辑回归来确定分级和体积进展之间的关联。
共有 399 名男性符合研究纳入标准。患者平均年龄为 61.8 岁，313 名（78%）为低危疾病。总体而言，231 名（58%）男性在重复活检时表现为稳定疾病。有 39 名（10%）男性的体积增加，定义为涉及的核心增加到 33%以上或最大单核心阳性增加到 50%以上，有 44 名（11%）男性的体积和分级增加。大约 10%的男性经历了癌症体积的减少。在多变量分析中，任何活检时分级和体积进展之间存在显著关联（OR 3.07），并且在 5 年内肿瘤长度（mm）增加一倍（OR 6.30）。
前列腺癌体积在每次活检时以相似的 10%的速度增加和减少。肿瘤体积的增加与早期重复活检时癌症分级的增加相关。然而，在一段时间内，癌症体积存在很大的变化。
