在进行主动监测且在疾病重新分类或进展后选择接受积极治疗的患者中预测肿瘤升级的临床因素。
Clinical Factors Predicting Tumour Upgrading in Patients Under Active Surveillance and Elected to Active Treatment after Disease Reclassification or Progression.
作者信息
Porcaro Antonio Benito, Cavicchioli Francesca, De Luyk Nicolò, Mattevi Daniele, Corsi Paolo, Sebben Marco, Tafuri Alessandro, Processali Tania, Inverardi Davide, Cacciamani Giovanni, De Marchi Davide, Balzarro Matteo, Cerruto Maria A, Brunelli Matteo, Novella Giovanni, Siracusano Salvatore, Artibani Walter
机构信息
Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
出版信息
Urol Int. 2017;99(2):186-193. doi: 10.1159/000457966. Epub 2017 Feb 14.
OBJECTIVES
To evaluate clinical factors associated with tumour upgrading (UPG) in low-intermediate risk patients who progressed while under active surveillance (AS) and underwent delayed radical prostatectomy.
MATERIAL AND METHODS
The evaluated factors included prostate specific antigen (PSA), prostate volume, PSA density and number of biopsy positive cores (BPC). Multivariate logistic regression by the forward step Wald procedure was used.
RESULTS
The study evaluated 24 patients who had UPG in 13 cases (54.2%). Independent factors associated with tumour UPG included PSA (OR 2.1; p = 0.047) and BPC (OR 2; p = 0.042).
CONCLUSIONS
Clinical factors associated with UPG were identified in patients who were under AS for with low-intermediate risk disease. Preoperative PSA levels and number of BPC were independent factors associated with UPG in a contemporary cohort of patients who progressed under AS and underwent delayed active treatment.
目的
评估在积极监测（AS）期间病情进展并接受延迟根治性前列腺切除术的低中危患者中，与肿瘤升级（UPG）相关的临床因素。
材料与方法
评估的因素包括前列腺特异性抗原（PSA）、前列腺体积、PSA密度和活检阳性核心数（BPC）。采用向前逐步Wald法进行多因素逻辑回归分析。
结果
该研究评估了24例患者，其中13例（54.2%）发生肿瘤升级。与肿瘤升级相关的独立因素包括PSA（比值比2.1；p = 0.047）和BPC（比值比2；p = 0.042）。
结论
在接受低中危疾病积极监测的患者中确定了与肿瘤升级相关的临床因素。术前PSA水平和BPC数量是当代一组在积极监测期间病情进展并接受延迟积极治疗的患者中与肿瘤升级相关的独立因素。
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