pT2 期前列腺癌患者行根治性前列腺切除术的生化复发和阳性手术切缘风险。

Risk of biochemical recurrence and positive surgical margins in patients with pT2 prostate cancer undergoing radical prostatectomy.

机构信息

Copenhagen Prostate Cancer Center, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Surg Oncol. 2014 Feb;109(2):132-8. doi: 10.1002/jso.23469. Epub 2013 Oct 24.

DOI:10.1002/jso.23469

PMID:24155174

Abstract

BACKGROUND AND OBJECTIVE

To investigate risk factors associated with positive surgical margins (PSM) and biochemical recurrence (BR) in organ confined tumors (pT2) after radical prostatectomy (RP) for localized prostate cancer (PCa).

METHODS

Between 1995 and 2011, 1,649 patients underwent RP at our institution. The study includes the 1,133 consecutive patients with pT2 tumors at final histopathology. Logistic regression analysis was used for risk of PSM. Risk of BR, defined as the first PSA ≥ 0.2 ng/ml, was analyzed with Kaplan-Meier and Cox regression analysis.

RESULTS

Median follow-up was 3.6 years (range: 0.5-15.5 years). In logistic regression, NS surgery was independently associated with an increased risk of pT2 PSM (OR = 1.68, 95% CI: 1.3-2.0, P = 0.01) relative to non-NS surgery. NS surgery was not independently associated with BR but the interaction of PSM and NS surgery trended (P = 0.08) to increase the risk of BR compared to PSM and non-NS surgery.

CONCLUSION

Several factors influence the risk of pT2 PSMs in radical prostatectomy. In our cohort pT2 PSM is associated with NS surgery and trend to increase risk of BR compared to non-NS surgery. The optimal selection of candidates for NS surgery is still not clear.

摘要

背景与目的

研究局限性前列腺癌（PCa）根治性前列腺切除术后（RP）器官局限性肿瘤（pT2）中与阳性切缘（PSM）和生化复发（BR）相关的危险因素。

方法

1995 年至 2011 年期间，有 1649 例患者在我院接受 RP。本研究包括 1133 例最终组织病理学检查为 pT2 肿瘤的连续患者。采用逻辑回归分析评估 PSM 的风险。采用 Kaplan-Meier 和 Cox 回归分析评估 BR 的风险，BR 定义为首次 PSA≥0.2ng/ml。

结果

中位随访时间为 3.6 年（范围：0.5-15.5 年）。在逻辑回归中，NS 手术与 pT2 PSM 的风险增加独立相关（OR=1.68，95%CI：1.3-2.0，P=0.01），而非 NS 手术。NS 手术与 BR 无独立相关性，但 PSM 和 NS 手术的相互作用有增加 BR 风险的趋势（P=0.08），与 PSM 和非 NS 手术相比。