Herden Jan, Heidenreich Axel, Wittekind Christian, Weissbach Lothar
Department of Urology, University Hospital Cologne, Cologne, Germany.
Department of Urology, University Hospital Cologne, Cologne, Germany.
Cancer Epidemiol. 2018 Oct;56:126-132. doi: 10.1016/j.canep.2018.08.007. Epub 2018 Aug 31.
According to the 8-edition of the tumor-nodes-metastasis-classification localized prostate cancer (PCa) can be divided into two categories (cT1,cT2), two stages (SI,SII), and, by incorporating prostate-specific-antigen (PSA) and WHO-grade (Gleason-Score), into prognostic stage groups (PSG I,IIA,IIB,IIC,III). We examined the predictive value of these systems for an organ-confined disease (pT≤2), favorable WHO-grade ≤2 (Gleason-score ≤7a), and biochemical-free-survival (BFS) after radical prostatectomy (RP).
Data were collected in a prospective, non-interventional, multicenter health-service-research study for the treatment of localized PCa (HAROW) with 687 patients receiving RP. Mean Follow-up was 31.7 months.
Organ-confined disease was present in 76.5% and 63.6% of cT1 and cT2 patients, 75.7% and 59.6% of SI and SII, and 84.6%, 81.6%, 72.8% and 42.5% of PSG I, IIA, IIB and ≥ IIC (p = 0.001). Favorable WHO-grade (Gleason-Score) was present in 75.4% and 60.7% of cT1 and cT2 patients, 74.3% and 56.5% of SI and SII patients, and 86.1%,85.6%,73.3% and 29.5% of PSG I, IIA, IIB and ≥ IIC (p = 0.001). Probability of BFS was 92.0% and 91.5% for cT1 and cT2 (p = 0.990), 91.1% and 94.2% for SI and S II (p = 0.286) and 96.6%,95.1%,91.4% and 78.8% for PSG I,IIA,IIB and ≥ IIC (p = 0.001).
CT 1/cT2 and S I/II subgrouping is feasible to predict a different pT-category and a favorable WHO-grade (Gleason-Score) after RP, but failed to predict a different BFS. With the additional information of WHO-grade (Gleason-Score) and PSA, the PSG represents an approach for the prediction of all examined endpoints which is a useful tool to help clinicians to advise their patients.
根据第八版肿瘤-淋巴结-转移分类，局限性前列腺癌（PCa）可分为两类（cT1、cT2）、两个阶段（SⅠ、SⅡ），并且通过纳入前列腺特异性抗原（PSA）和世界卫生组织分级（ Gleason评分），分为预后阶段组（PSGⅠ、ⅡA、ⅡB、ⅡC、Ⅲ）。我们研究了这些系统对根治性前列腺切除术（RP）后器官局限性疾病（pT≤2）、良好的世界卫生组织分级≤2（Gleason评分≤7a）以及无生化复发生存（BFS）的预测价值。
在一项前瞻性、非干预性、多中心卫生服务研究中收集数据，该研究用于治疗局限性PCa（HAROW），有687例患者接受了RP。平均随访时间为31.7个月。
cT1和cT2患者中分别有76.5%和63.6%存在器官局限性疾病，SⅠ和SⅡ患者中分别有75.7%和59.6%存在，PSGⅠ、ⅡA、ⅡB和≥ⅡC患者中分别有84.6%、81.6%、72.8%和42.5%存在（p = 0.001）。cT1和cT2患者中分别有75.4%和60.7%具有良好的世界卫生组织分级（Gleason评分），SⅠ和SⅡ患者中分别有74.3%和56.5%具有，PSGⅠ、ⅡA、ⅡB和≥ⅡC患者中分别有86.1%、85.
