Virginia Mason Medical Center , Seattle.
Center for Prostate Disease Research, Department of Defense , Rockville.
J Urol. 2019 May;201(5):916-922. doi: 10.1097/JU.0000000000000024.
The aim of this study was to identify the effects of subsequent prostate needle biopsies after the baseline biopsy on health related quality of life with time. We compared men with and without prostate cancer, and men who did and did not undergo followup prostate needle biopsy.
Included in analysis were patients enrolled in the Center for Prostate Disease Research Multicenter National Database between 2007 and 2015 who had low or favorable intermediate risk prostate cancer, were on active surveillance and underwent prostate needle biopsy for suspicion of prostate cancer. Patients completed the EPIC (Expanded Prostate Cancer Index Composite) and the RAND SF-36 (36-Item Short Form Health Survey) after baseline biopsy and at regular followup intervals. Mean health related quality of life was compared with time between patients who did and did not undergo subsequent prostate needle biopsies following baseline.
Of the 637 patients included in study 129 (20.3%) with prostate cancer were on active surveillance and 508 (79.7%) were in the noncancer group. In the cancer and noncancer groups mean ± SD followup was 34.7 ± 16.9 and 31.6 ± 14.6 months, respectively. Of the patients with prostate cancer 54 (60.7%) underwent subsequent prostate needle biopsies compared with 114 (27.1%) without cancer. No significant impact on health related quality of life was observed in men who underwent subsequent prostate needle biopsies during a 5-year period.
A subsequent prostate needle biopsy is required in most active surveillance protocols and in men with persistent suspicion of prostate cancer. Our analysis shows that subsequent prostate needle biopsies do not significantly impact health related quality of life.
本研究旨在确定基线活检后进行后续前列腺穿刺活检对健康相关生活质量的影响随时间的变化。我们比较了有和没有前列腺癌的男性，以及进行和未进行随访前列腺穿刺活检的男性。
分析纳入了 2007 年至 2015 年期间在前列腺疾病研究中心多中心国家数据库中登记的低危或中危前列腺癌、接受主动监测并因怀疑前列腺癌而接受前列腺穿刺活检的患者。患者在基线活检后和定期随访间隔时间内完成 EPIC（前列腺癌指数综合量表扩展版）和 RAND SF-36（36 项简短健康调查问卷）。比较基线后行或不行后续前列腺穿刺活检的患者之间随时间变化的健康相关生活质量的平均值。
在纳入研究的 637 例患者中，有 129 例（20.3%）患有前列腺癌，正在接受主动监测，508 例（79.7%）为非癌症组。在癌症和非癌症组中，平均随访时间分别为 34.7 ± 16.9 和 31.6 ± 14.6 个月。在患有前列腺癌的患者中，有 54 例（60.7%）进行了后续前列腺穿刺活检，而无癌症的患者有 114 例（27.1%）。在 5 年期间，进行后续前列腺穿刺活检的男性健康相关生活质量无显著影响。
大多数主动监测方案和对前列腺癌持续怀疑的男性都需要进行后续前列腺穿刺活检。我们的分析表明，后续前列腺穿刺活检不会显著影响健康相关生活质量。
