糖尿病和β-肾上腺素能阻滞剂是转移性前列腺癌的危险因素。
Diabetes and beta-adrenergic blockage are risk factors for metastatic prostate cancer.
作者信息
Krönig Malte, Haverkamp Christian, Schulte Antonia, Heinicke Laura, Schaal Kathrin, Drendel Vanessa, Werner Martin, Wetterauer Ulrich, Schultze-Seemann Wolfgang, Jilg Cordula Annette
机构信息
Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
Department of Urology, University of Freiburg Medical Centre, Hugstetter Strasse 55, 79106, Freiburg, Germany.
出版信息
World J Surg Oncol. 2017 Feb 21;15(1):50. doi: 10.1186/s12957-017-1117-4.
BACKGROUND
We evaluated the influence of comorbidity inferred risks for lymph node metastasis (pN1) and positive surgical margins (R1) after radical prostatectomy in order to optimize pretherapeutic risk classification. We analyzed 454 patients after radical prostatectomy (RP) between 2009 and 2014. Comorbidities were defined by patients' medication from our electronic patient chart and stratified according to the ATC WHO code. Endpoints were lymph node metastasis (pN1) and positive surgical margins (R1).
RESULTS
Rates for pN1 and R1 were 21.4% (97/454) and 29.3% (133/454), respectively. In addition to CAPRA and Gleason score, we identified diabetes as a significant medication inferred risk factor for pN1 (OR 2.9, p = 0.004/OR 3.2, p = 0.001/OR 3.5, p = 0.001) and beta-blockers for R1 (OR 1.9, p = 0.020/OR 2.9, p = 0.004). Patients with diabetes showed no statistically significant difference in Gleason score, CAPRA Score, PSA, and age compared to non-diabetic patients.
CONCLUSIONS
We identified diabetes and beta1 adrenergic blockage as significant risk factors for lymph node metastasis and positive surgical margins in prostate cancer (PCa). Patients at risk will need intensive pretherapeutic staging for optimal therapeutic stratification.
背景
我们评估了合并症对根治性前列腺切除术后淋巴结转移（pN1）和手术切缘阳性（R1）的推断风险的影响，以优化治疗前的风险分类。我们分析了2009年至2014年间454例接受根治性前列腺切除术（RP）的患者。合并症根据患者电子病历中的用药情况定义，并根据世界卫生组织药物解剖学治疗学化学代码进行分层。观察终点为淋巴结转移（pN1）和手术切缘阳性（R1）。
结果
pN1和R1的发生率分别为21.4%（97/454）和29.3%（133/454）。除了CAPRA和Gleason评分外，我们还确定糖尿病是pN1的一个重要用药推断风险因素（比值比2.9，p = 0.004/比值比3.2，p = 0.001/比值比3.5，p = 0.001），而β受体阻滞剂是R1的风险因素（比值比1.9，p = 0.020/比值比2.9，p = 0.004）。与非糖尿病患者相比，糖尿病患者在Gleason评分、CAPRA评分、前列腺特异性抗原（PSA）和年龄方面无统计学显著差异。
结论
我们确定糖尿病和β1肾上腺素能阻滞是前列腺癌（PCa）淋巴结转移和手术切缘阳性的重要风险因素。有风险的患者需要进行强化的治疗前分期，以实现最佳的治疗分层。
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