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病理局限于器官的前列腺癌亚分类(pT2期)的预后价值:美国癌症联合委员会(AJCC)第8版分期系统引入的变化的确认。

Prognostic value of subclassification (pT2 stage) of pathologically organ-confined prostate cancer: Confirmation of the changes introduced in the 8th edition of the American Joint Committee on Cancer (AJCC) staging system.

作者信息

Antunes Hugo Pontes, Parada Belmiro, Carvalho João, Eliseu Miguel, Jarimba Roberto, Oliveira Rui, Tavares-da-Silva Edgar, Figueiredo Arnaldo

机构信息

Department of Urology and Renal Transplantation, Coimbra University Hospital Center.

出版信息

Arch Ital Urol Androl. 2018 Sep 30;90(3):191-194. doi: 10.4081/aiua.2018.3.191.

DOI:10.4081/aiua.2018.3.191
PMID:30362685
Abstract

OBJECTIVE

The last edition of the AJCC staging system eliminated the pT2 subclassification of prostate cancer (PCa). Our objective was to evaluate the association of pT2 subclassification with the oncological results of patients with PCa who underwent radical prostatectomy (RP).

MATERIAL AND METHODS

We evaluated 367 patients who underwent RP between 2009 and 2016, with pT2 disease in the final pathological evaluation. We assessed differences in rates of biochemical recurrence (BCR), metastasis and mortality between T2 substages (pT2a/b vs pT2c).

RESULTS

Fifty-three (14.4%) patients presented pT2a/b disease and 314 (85.6%) pT2c disease. The mean follow-up time was 4.9 ± 2.6 years. Grade group scores (p = 0.1) and prostate specific antigen (PSA) (p = 0.2) did not differed between pT2 substages. The rate of BCR in pT2a/b and pT2c patients was 11.3% and 18.2%, respectively (p = 0.2). Five (9.4%) patients with pT2a/b and 45 (14.3%) with pT2c substage underwent salvage radiotherapy (p = 0.3). The rate of positive surgical margins did not differ between groups (p = 0.2). Seven (2.2%) patients with pT2c had lymph nodes or distant metastases. The overall survival was 92.5% and 93.6% in pT2a/b and pT2c, respectively (p = 0.2).

CONCLUSION

Our results are in accordance with the changes introduced in the 8th edition of the AJCC staging system in which the pT2 subclassification was eliminated.

摘要

目的

美国癌症联合委员会(AJCC)分期系统的上一版取消了前列腺癌(PCa)的pT2亚分类。我们的目的是评估pT2亚分类与接受根治性前列腺切除术(RP)的PCa患者肿瘤学结果之间的关联。

材料与方法

我们评估了2009年至2016年间接受RP且最终病理评估为pT2疾病的367例患者。我们评估了T2亚阶段(pT2a/b与pT2c)之间生化复发(BCR)、转移和死亡率的差异。

结果

53例(14.4%)患者为pT2a/b疾病,314例(85.6%)为pT2c疾病。平均随访时间为4.9±2.6年。pT2亚阶段之间的分级组评分(p = 0.1)和前列腺特异性抗原(PSA)(p = 0.2)没有差异。pT2a/b和pT2c患者的BCR发生率分别为11.3%和18.2%(p = 0.2)。5例(9.4%)pT2a/b患者和45例(14.3%)pT2c亚阶段患者接受了挽救性放疗(p = 0.3)。两组之间手术切缘阳性率没有差异(p = 0.2)。7例(2.2%)pT2c患者有淋巴结或远处转移。pT2a/b和pT2c患者的总生存率分别为92.5%和93.6%(p = 0.2)。

结论

我们的结果与AJCC分期系统第8版引入的变化一致,其中取消了pT2亚分类。

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Investig Clin Urol. 2020 Jan;61(1):35-41. doi: 10.4111/icu.2020.61.1.35. Epub 2019 Dec 2.