根治性前列腺切除术后 pT0 前列腺癌的当代临床病理特征：一项基于人群的研究。
Contemporary clinicopathological characteristics of pT0 prostate cancer at radical prostatectomy: A population-based study.
机构信息
Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
出版信息
Urol Oncol. 2019 Oct;37(10):696-701. doi: 10.1016/j.urolonc.2019.05.001. Epub 2019 May 22.
BACKGROUND
The incidence of pT0 prostate cancer (CaP) at radical prostatectomy (RP) is extremely rare. We performed the first population-based analysis of pT0 CaP at RP.
METHODS
Within the Surveillance, Epidemiology, and End Results database (2004-2015), we tested for clinical and pathological characteristics according to pT0 vs. non-pT0 CaP and included a multivariable logistic regression model.
RESULTS
pT0 was identified in 358 (0.2%) out of 160,532 clinically localized RP patients. The majority of pT0 patients presented with initial prostate-specific antigen (PSA) <10 ng/ml (82.4%), harboured biopsy Gleason score (GS) 6 (69.8%) and cT1 disease (78.1%). Nonetheless, pT0 was identified in 13 (3.6%) patients with PSA ≥20 ng/ml, in 69 (19.3%) patients with biopsy GS ≥7 and in 78 (21.8%) patients with ≥cT2 disease. In a subset of patients with available number of biopsy cores, pT0 was identified in 34 (33.3%) patients with ≥2 positive biopsy cores. Age, race, marital status, hospital region, population density, PSA, as well as number of biopsy cores did not discriminate between pT0 and non-pT0 cases. Analyses according to annual rates (2004-2015) of pT0 did not vary between the years (0.2%-1.6%, estimated annual percent change: -1.6%, P = 0.3). Neither did the rates vary according to geographic region.
CONCLUSIONS
pT0 at RP is very rare. Even though, most pT0 patients have low PSA, low clinical stage, low biopsy GS, and only one positive biopsy core, those with more aggressive characteristics can still harbour pT0 at RP.
背景
在根治性前列腺切除术（RP）中，pT0 前列腺癌（CaP）的发病率极低。我们首次对 RP 中的 pT0 CaP 进行了基于人群的分析。
方法
在监测、流行病学和最终结果数据库（2004-2015 年）中，我们根据 pT0 与非 pT0 CaP 进行了临床和病理特征检测，并纳入了多变量逻辑回归模型。
结果
在 160532 例临床局限性 RP 患者中，有 358 例（0.2%）被诊断为 pT0。大多数 pT0 患者的初始前列腺特异性抗原（PSA）<10ng/ml（82.4%），活检 Gleason 评分（GS）为 6（69.8%）且 cT1 期（78.1%）。尽管如此，仍有 13 例（3.6%）PSA≥20ng/ml、69 例（19.3%）活检 GS≥7 和 78 例（21.8%）≥cT2 期患者被诊断为 pT0。在可获得活检核心数量的患者亚组中，有 34 例（33.3%）患者有≥2 个阳性活检核心被诊断为 pT0。年龄、种族、婚姻状况、医院所在地区、人口密度、PSA 以及活检核心数量均不能区分 pT0 与非 pT0 病例。根据 pT0 的年度发生率（2004-2015 年）进行的分析，各年份之间没有差异（0.2%-1.6%，估计年度百分比变化：-1.6%，P=0.3）。地理区域也没有差异。
结论
RP 中的 pT0 非常罕见。尽管如此，大多数 pT0 患者的 PSA 较低、临床分期较低、活检 GS 较低且只有一个阳性活检核心，但仍有一些侵袭性特征较强的患者在 RP 中存在 pT0。
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