Guijarro A, Hernández V, de la Morena J M, Jiménez-Valladolid I, Pérez-Fernández E, de la Peña E, Llorente C
Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
Servicio de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
Actas Urol Esp. 2017 May;41(4):226-233. doi: 10.1016/j.acuro.2016.09.004.
The prognosis of patients diagnosed with metastatic prostate cancer seems to be modulated by factors such as the number and site of metastases. Our objective is to evaluate survival outcomes according to the number and site of metastases in our series of metastatic patients over the last 15 years.
A retrospective analysis was performed on patients diagnosed between 1998 and 2014. We analyzed overall survival and progression-free survival, depending on the number and location of metastases on patients with newly diagnosed metastatic prostate cancer. Other potential prognostic factors were also evaluated: age, clinical stage, PSA at diagnosis, Gleason, PSA nadir, time till PSA nadir and first-line or second-line treatment after progression.
We analyzed a series of 162 patients. The mean age was 72.7yr (SD: 8.5). The estimated median overall survival was 3.9 yr (95% CI 2.6-5.2). The overall survival in patients with only lymph node metastases was 7 yr (95% CI 4.1-9.7), 3.9 (95%CI 2.3-5.5) in patients with only bone metastases, 2.5 yr (95% CI 2-2.3) in lymph nodes and bone metastases, and 2.2 yr (95% CI 1.4-3) in patients with visceral metastases (P<.001). In multivariate analysis, the location of metastasesis significantly associated with overall survival and progression-free survival. The number of metastases showed no association with survival.
The site of metastases has a clear impact on both overall survival and progression-free survival. Patients with only lymph node involvement had a better prognosis. The number of metastases showed no significant impact on survival in our series.
被诊断为转移性前列腺癌患者的预后似乎受到转移灶数量和部位等因素的调节。我们的目标是根据过去15年我们系列转移性患者转移灶的数量和部位来评估生存结果。
对1998年至2014年期间诊断的患者进行回顾性分析。我们根据新诊断的转移性前列腺癌患者转移灶的数量和位置分析总生存期和无进展生存期。还评估了其他潜在的预后因素：年龄、临床分期、诊断时的前列腺特异性抗原（PSA）、 Gleason评分、PSA最低点、达到PSA最低点的时间以及进展后的一线或二线治疗。
我们分析了162例患者。平均年龄为72.7岁（标准差：8.5）。估计的中位总生存期为3.9年（95%置信区间2.6 - 5.2）。仅发生淋巴结转移的患者总生存期为7年（95%置信区间4.1 - 9.7），仅发生骨转移的患者为3.9年（95%置信区间2.3 - 5.5），同时发生淋巴结和骨转移的患者为2.5年（95%置信区间2 - 2.3），发生内脏转移的患者为2.2年（95%置信区间1.4 - 3）（P<0.001）。在多变量分析中，转移灶的位置与总生存期和无进展生存期显著相关。转移灶数量与生存无关联。
转移灶部位对总生存期和无进展生存期均有明显影响。仅累及淋巴结的患者预后较好。在我们的系列研究中，转移灶数量对生存无显著影响。
