Guo Yadong, Mao Shiyu, Zhang Aihong, Wang Ruiliang, Zhang Ziwei, Zhang Junfeng, Wang Longsheng, Zhang Wentao, Wu Yuan, Ye Lin, Yang Bin, Yao Xudong
Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, P.R. China.
Department of Medical Statistics, Tongji University School of Medicine, Shanghai, 200092, P.R. China.
J Cancer. 2019 Jan 1;10(3):556-567. doi: 10.7150/jca.29481. eCollection 2019.
This study compared the clinicopathological features and survival of metastatic prostate cancer (mPCa) after stratification by age and non-bone-related metastasis to identify prognostic factors. Patients with mPCa between 2010 and 2015 were identified from the Surveillance, Epidemiology and End Results database and analyzed. The overall survival (OS) rate was assessed using the Kaplan-Meier curve and log-rank test as well as multivariate Cox regression analysis. Among the 10147 patients with mPCa, 5378 were classified as young (≤70 years), 3140 were classified as middle-aged (70-82 years), and 1629 were classified as elderly (> 82 years). The younger patients with a single site metastasis with non-regional lymph nodes (NRLN) had a better prognosis than those with bone metastasis [hazard ratio (HR), 0.59, 95% confidence interval (CI), 0.47-0.73, P < 0.001], whereas patients with liver metastasis had the worst OS rate (P = 0.001). Moreover, patients in the middle-aged group with NRLN or lung metastasis had a better prognosis than those with bone metastasis (P < 0.05). The OS rate of patient with bone + liver and bone + brain metastasis was poorer (P < 0.001) than those with bone + NRLN metastasis in the younger patients (P < 0.05). The elder patients with bone + lung metastasis had the worst OS (HR, 1.54; 95% CI, 1.25-1.90, P < 0.001), although the death risk of patients with bone + brain and bone + NRLN metastasis not significantly different (P > 0.05). However, the OS of the patients with bone + liver metastasis remained the worst (P < 0.001). Prostate cancer patients with lung metastasis or younger patients (≤70 years old) with bone + lung metastases had better OS than patients with other types of metastasis or old age.
本研究通过年龄和非骨转移进行分层，比较转移性前列腺癌（mPCa）的临床病理特征和生存率，以确定预后因素。从监测、流行病学和最终结果数据库中识别并分析了2010年至2015年间的mPCa患者。使用Kaplan-Meier曲线、对数秩检验以及多变量Cox回归分析评估总生存率（OS）。在10147例mPCa患者中，5378例被分类为年轻患者（≤70岁），3140例被分类为中年患者（70 - 82岁），1629例被分类为老年患者（>82岁）。单一部位转移且无区域淋巴结（NRLN）转移的年轻患者预后优于骨转移患者[风险比（HR），0.59，95%置信区间（CI），0.47 - 0.73，P < 0.001]，而肝转移患者的OS率最差（P = 0.001）。此外，中年组中出现NRLN转移或肺转移的患者预后优于骨转移患者（P < 0.05）。年轻患者中，骨 + 肝转移和骨 + 脑转移患者的OS率低于骨 + NRLN转移患者（P < 0.05）（P < 0.001）。老年患者中，骨 + 肺转移患者的OS最差（HR，1.54；95%CI，1.25 - 1.90，P < 0.001），尽管骨 + 脑转移和骨 + NRLN转移患者的死亡风险无显著差异（P > 0.05）。然而，骨 + 肝转移患者的OS仍然最差（P < 0.001）。发生肺转移的前列腺癌患者或年龄较小（≤70岁）且发生骨 + 肺转移的患者，其OS优于其他类型转移患者或老年患者。
