Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea.
Biometrics Research Branch, Division of Cancer Epidemiology and Prevention, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea.
Biomed Res Int. 2018 Dec 6;2018:4307207. doi: 10.1155/2018/4307207. eCollection 2018.
This study aimed to investigate the effect of neoadjuvant hormone therapy (NHT) on resection margin positivity, biochemical-recurrence- (BCR-) free survival, and overall survival (OS) in 176 patients with locally advanced prostate cancer (LAPC) treated with radical prostatectomy using propensity-score matching, including 79 (44.9%) patients treated with the NHT. Fifty pairs of one-to-one propensity-score matching were matched to investigate the pure effect of NHT on resection margin positivity, BCR, and OS with a statistical significance of <0.050. Before matching, NHT, tumor volume percentage, and extracapsular extension were significant factors for resection margin positivity (≤0.001); however, after matching, NHT became insignificant in the multivariate analysis (=0.084). In the survival analysis, NHT was not associated with BCR or OS before and after matching (BCR: hazard ratio, 1.35 and 0.84, respectively; OS: hazard ratio, 1.05 and 0.77, respectively; ≥0.539 for all). Conversely, PSA level (HR, 2.23), extracapsular extension (HR, 2.10), and lymphovascular invasion (HR, 1.85) were significant factors for BCR (≤0.001 for all), but none were significant factors for OS in the propensity-score matching analysis (≥0.948). Therefore, NHT was not a significant factor for resection margin positivity, BCR-free survival, and OS before and after propensity-score matching in patients with LAPC.
本研究旨在通过倾向评分匹配，调查新辅助激素治疗（NHT）对 176 例局部晚期前列腺癌（LAPC）患者根治性前列腺切除术后切缘阳性、生化无复发生存（BCR）和总生存（OS）的影响，其中 79 例（44.9%）患者接受了 NHT 治疗。进行了 50 对一对一的倾向评分匹配，以调查 NHT 对切缘阳性、BCR 和 OS 的纯效应，统计学意义为 <0.050。在匹配之前，NHT、肿瘤体积百分比和包膜外延伸是切缘阳性（≤0.001）的显著因素；然而，在多变量分析中，NHT 后无统计学意义（=0.084）。在生存分析中，匹配前后 NHT 与 BCR 或 OS 均无关（BCR：危险比分别为 1.35 和 0.84；OS：危险比分别为 1.05 和 0.77；均≥0.539）。相反，PSA 水平（HR，2.23）、包膜外延伸（HR，2.10）和脉管侵犯（HR，1.85）是 BCR 的显著因素（均≤0.001），但在倾向评分匹配分析中，这些因素均不是 OS 的显著因素（均≥0.948）。因此，在 LAPC 患者中，NHT 不是切缘阳性、BCR 无复发生存和 OS 的显著因素。
