Department of Surgery, Vestre Viken Hospital Trust, 3004, Drammen, Norway.
Cancer Registry of Norway, Ullernchausseen 64, 0379, Oslo, Norway.
World J Urol. 2019 Aug;37(8):1571-1580. doi: 10.1007/s00345-018-2570-6. Epub 2018 Nov 27.
To study the association between time from diagnosis to radical prostatectomy (RP-interval) and prostate cancer-specific mortality (PCSM), histological findings in the RP-specimen and failure after RP (RP-failure).
Patients diagnosed with non-metastatic prostate cancer (PCa) in 2001-2010 and prostatectomized within 180 days of biopsy were identified in the Cancer Registry of Norway and the Norwegian Prostate Cancer Registry. Patients were stratified according to risk groups and RP-intervals of 0-60, 61-90, 91-120 and 121-180 days. Aalen-Johansen and Kaplan-Meier methods estimated curves for PCSM, RP-failure and overall mortality. Multivariable Cox regressions and Chi-square tests were used to evaluate the impact of RP-interval on outcomes.
In 5163 eligible patients, the median time from diagnosis to RP was 93 days (range 1-180). Risk group distribution was similar in all RP-interval groups. With almost eight years of observation, no association was found between RP-interval and PCSM in the intermediate-or high-risk groups. Increasing RP-interval did not increase the rate of adverse histological outcomes or incidence of RP-failure.
Increasing RP-interval up to 180 days was not associated with adverse oncological outcomes at eight years follow-up. These findings should be considered when planning for prostatectomy.
研究从诊断到根治性前列腺切除术(RP 间隔)与前列腺癌特异性死亡率(PCSM)之间的关联,RP 标本中的组织学发现以及 RP 后失败(RP 失败)。
在挪威癌症登记处和挪威前列腺癌登记处中确定了 2001-2010 年间诊断为非转移性前列腺癌(PCa)并在活检后 180 天内接受前列腺切除术的患者。患者根据风险组和 RP 间隔 0-60、61-90、91-120 和 121-180 天进行分层。Aalen-Johansen 和 Kaplan-Meier 方法估计了 PCSM、RP 失败和总死亡率的曲线。多变量 Cox 回归和卡方检验用于评估 RP 间隔对结果的影响。
在 5163 名合格患者中,从诊断到 RP 的中位时间为 93 天(范围为 1-180)。所有 RP 间隔组的风险组分布相似。经过近八年的观察,在中高危组中,RP 间隔与 PCSM 之间没有关联。随着 RP 间隔的增加,不良组织学结果或 RP 失败的发生率并没有增加。
在八年的随访中,RP 间隔增加到 180 天与不良肿瘤学结果无关。在计划前列腺切除术时应考虑这些发现。