Soga Norihito, Ogura Yuji, Wakita Toshiaki, Kageyama Takumi, Furusawa Jun
Department of Urology, Aichi Cancer Center Hospital, Nagoya.
Department of Urology, Wakita Clinic, Aichi.
Curr Urol. 2019 Sep;13(1):25-30. doi: 10.1159/000499298. Epub 2019 Sep 10.
We used a new GP score (Gleason score multiplied by prostate-specific antigen) without the T stage as a predictive value for biochemical failure (BCF) after prostatectomy.
We assessed 459 prostate cancer patients who underwent prostatectomies at our institution. Three sub-groups were defined in terms of D'Amico classification risk (low, intermediate, and high) and Gleason score (low, < 50; intermediate, 50-100; and high GP score, > 100). Risk factors for BCF were evaluated by multivariate analysis with a Cox hazard model. A log-rank test was used to compare the BCF rate in the 2 groups.
There was nosignificant difference in the non-BCF rate between the lowrisk and low GP score subgroups or the intermediate risk andintermediate GP score subgroups. In contrast, the non-BCFrate of the high GP score subgroup (42.1%) was significantlylower than that of the high-risk subgroup (66.1%, log-rankp = 0.008). Based on multivariate analysis, a high GP score(p = 0.001; HR 3.78; 95%CI 1.95-7.35) was a significant independent risk factor for BCF after prostatectomy.
The GP score, consisting of two absolute numbers, may be a valuable predictive factor for BCF after prostatectomy, especially in the high-risk failure group.
我们使用一种新的GP评分(Gleason评分乘以前列腺特异性抗原),不考虑T分期,作为前列腺切除术后生化复发(BCF)的预测指标。
我们评估了在本机构接受前列腺切除术的459例前列腺癌患者。根据D'Amico分类风险(低、中、高)和Gleason评分(低,<50;中,50 - 100;高GP评分,>100)定义了三个亚组。通过Cox风险模型进行多因素分析评估BCF的危险因素。采用对数秩检验比较两组的BCF发生率。
低风险和低GP评分亚组之间或中风险和中GP评分亚组之间的无BCF发生率无显著差异。相比之下,高GP评分亚组的无BCF发生率(42.1%)显著低于高风险亚组(66.1%,对数秩检验p = 0.008)。基于多因素分析,高GP评分(p = 0.001;风险比3.78;95%置信区间1.95 - 7.35)是前列腺切除术后BCF的显著独立危险因素。
由两个绝对值组成的GP评分可能是前列腺切除术后BCF的有价值预测因素,尤其是在高风险复发组。