Poulsen Mads Hvid, Jakobsen Jørn Skibsted, Mortensen Mike Allan, Høilund-Carlsen Poul Flemming, Lund Lars
Department of Urology, Odense University Hospital, Odense, Denmark.
Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
Res Rep Urol. 2019 Jul 30;11:215-221. doi: 10.2147/RRU.S190140. eCollection 2019.
The effect of curative treatment for oligometastatic prostate cancer patients is unsolved, both with regard to morbidity and mortality. With this study, we provide some of the first long-term follow-up data on progression and mortality in oligometastatic prostate cancer patients after curative treatment of their primary tumor. A cohort of 210 patients with diagnosed prostate cancer was established between 2008 and 2010. All patients were scheduled for intended curative treatment, and all underwent blinded F-choline positron-emission tomography/computed tomography at inclusion prior to curative treatment. Upon unblinding, 12 patients (6%) were recategorized as being oligometastatic. They had a mean age of 64 years, median prostate-specific antigen of 18 ng/mL, and median Gleason score of 7. Six patients were staged as T3, one T2, and five T1. The patients had a median of one bone metastasis (range 1-2). All underwent intended curative radiotherapy or prostatectomy. Mean follow-up was 10.1 (8.9-11.0) years. During follow-up of the 12 patients, three (25%) had biochemical recurrence, two developed castration-resistant disease, and one died due to prostate cancer. Our results suggest that intended curative treatment of the primary tumor in oligometastatic prostate cancer may have a role in highly selected patients.
对于寡转移前列腺癌患者，无论是发病率还是死亡率方面，其根治性治疗的效果都尚未明确。通过本研究，我们提供了一些关于寡转移前列腺癌患者原发肿瘤接受根治性治疗后进展和死亡率的首批长期随访数据。2008年至2010年间建立了一个包含210例确诊前列腺癌患者的队列。所有患者均计划接受根治性治疗，且在根治性治疗前纳入研究时均接受了盲法F-胆碱正电子发射断层扫描/计算机断层扫描。解除盲法后，12例患者（6%）被重新分类为寡转移。他们的平均年龄为64岁，前列腺特异性抗原中位数为18 ng/mL，Gleason评分中位数为7。6例患者分期为T3，1例为T2，5例为T1。患者骨转移的中位数为1处（范围1 - 2处）。所有患者均接受了计划的根治性放疗或前列腺切除术。平均随访时间为10.1（8.9 - 11.0）年。在对这12例患者的随访期间，3例（25%）出现生化复发，2例发展为去势抵抗性疾病，1例死于前列腺癌。我们的结果表明，对于寡转移前列腺癌患者，对原发肿瘤进行计划的根治性治疗可能在经过严格筛选的患者中发挥作用。
