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前列腺癌诊断与手术治疗之间的时间间隔对病理和临床结局的影响:这有关系吗?

Time between diagnosis and surgical treatment on pathological and clinical outcomes in prostate cancer: does it matter?

机构信息

Barretos Cancer Hospital, Alameda Nicaragua 252, Bairro City, Barretos, SP, Brazil.

出版信息

World J Urol. 2018 Aug;36(8):1225-1231. doi: 10.1007/s00345-018-2251-5. Epub 2018 Mar 16.

Abstract

INTRODUCTION

Prostate cancer (PC) most of the time presents with an indolent course. Thus, delays in treatment due to any causes might not affect long-term survival and may not affect cancer cure rates.

PURPOSE

In this study, we evaluated the effect of delay-time between PC diagnosis and radical prostatectomy regarding oncological outcomes: Gleason score upgrade on surgical specimen, pathologic extracapsular extension (ECE) on surgical specimen, and postoperative biochemical recurrence (BCR) on follow-up.

METHODS

We evaluated PC patients who underwent radical prostatectomy (RP) regarding clinical and pathological findings and theirs respective interval between diagnosis and surgical treatment measured in days and months. We used univariate and multivariate logistic regression to evaluate the impact of interval-time.

RESULTS

A total of 908 PC patients underwent RP between 2006 and 2014. Mean age was 61.5 years, the mean time-to-surgery was 191 days (> 6 months) and 187 (20.5%) patients had BCR, with a mean follow-up of 44 months. According to our analysis, no statistically significant maximum cut-off time interval between diagnostic biopsy and surgery could be established (p = 0.215). Regardless of interval-time: ≤ 6 months (56.5%), 6-12 months (38.5%), and > 12 months (5.1%) after biopsy, we found no time interval correlated with poor oncological outcomes. This study has several limitations. It was retrospective and had a mean follow-up of 4 years. Additional follow-up is necessary to determine whether these findings will be maintained over time.

CONCLUSIONS

We showed that the time between diagnosis and surgical treatment did not affect the oncological outcomes in our study.

摘要

简介

前列腺癌(PC)通常表现为惰性病程。因此,由于任何原因导致的治疗延迟都不会影响长期生存,也不会影响癌症治愈率。

目的

在这项研究中,我们评估了 PC 诊断与根治性前列腺切除术之间的延迟时间对肿瘤学结果的影响:手术标本上的 Gleason 评分升级、手术标本上的病理性包膜外扩展(ECE)和术后生化复发(BCR)在随访中。

方法

我们评估了接受根治性前列腺切除术(RP)的 PC 患者的临床和病理发现,以及从诊断到手术治疗的各自间隔时间,以天数和月数衡量。我们使用单变量和多变量逻辑回归来评估间隔时间的影响。

结果

共有 908 名 PC 患者于 2006 年至 2014 年期间接受 RP。平均年龄为 61.5 岁,平均手术时间为 191 天(>6 个月),187 名(20.5%)患者出现 BCR,平均随访时间为 44 个月。根据我们的分析,在诊断活检和手术之间,无法确定具有统计学意义的最大时间间隔截止值(p=0.215)。无论间隔时间如何:活检后≤6 个月(56.5%)、6-12 个月(38.5%)和>12 个月(5.1%),我们都没有发现与不良肿瘤学结果相关的时间间隔。本研究存在一些局限性。它是回顾性的,平均随访时间为 4 年。需要进一步随访以确定这些发现是否会随着时间的推移而保持。

结论

我们表明,在我们的研究中,诊断与手术治疗之间的时间间隔不会影响肿瘤学结果。

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