Kang Yongming, Song Pan, Fang Kun, Yang Bo, Yang Luchen, Zhou Jing, Wang Linchuan, Dong Qiang
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Department of Urology, Suining Central Hospital, Suining, 629000, Sichuan Province, China.
J Cancer. 2020 Sep 17;11(22):6484-6490. doi: 10.7150/jca.40428. eCollection 2020.
To evaluate the prostate cancer-specific survival (PCSS) of low T stages or low prostate-specific antigens (PSA) levels in men with high-grade prostate cancer. Patients with non-metastatic prostate cancer (T1-4N0M0) and Gleason score 8-10 in the Surveillance, Epidemiology, and End Results database from 2004-2010 were identified. These men were stratified by T stages (T1, T2, T3a, T3b-4) and PSA levels (<4.0 ng/ml, 4.0-10.0 ng/ml, 10.1-20.0 ng/ml, >20.0 ng/ml). Propensity-score matching (PSM) was conducted to balance the covariates. Kaplan-Meier analysis and multivariable Cox regressions were performed to analyze the PCSS in different T stage or PSA levels groups. A total of 33231 patients aging 69(6276) years were identified. The overall cohort results showed that the PCSS of T1 group was significantly worse than that of T2 and T3a groups [T2 HR: 0.62(0.570.67); T3 HR: 0.70(0.630.77)]. There were no significant difference between T2 and T3a groups [T2 HR: 0.98 (0.911.05)]. The PSA <4.0 ng/ml group had significantly worse PCSS than PSA 4.0-10.0 ng/ml [PSA 4.0-10.0 ng/ml HR: 0.77(0.680.88)]. PSM methods were implemented in the comparison of T1 vs T2, T1 vs T3a, T2 vs T3a. and PSA< 4.0 ng/ml vs PSA 4.0-10.0 ng/ml, The results in these matched cohorts showed that T1 group was associated with significantly worse PCSS than T2 group [T1 HR: 1.31(1.201.44)] and T3a group [T1 HR: 1.33(1.161.52)]. There were no significant differences between T2 and T3a groups [T3a HR: 1.14(0.991.32)]. The PCSS of patients with PSA< 4.0 ng/ml was significantly worse that these with PSA 4.0-10.0 ng/ml in the matched cohort [PSA< 4.0 ng/ml HR: 1.3(1.08~1.56)]. For patients with high-grade PCa, the PCSS of patients seems to be worse in the T1 stage than those in T2 and T3a stages. Patients with PSA <4.0 ng/ml appears to have poorer prognosis than those with PSA 4.0-10.0 ng/ml.
评估高分级前列腺癌男性患者低T分期或低前列腺特异性抗原（PSA）水平下的前列腺癌特异性生存（PCSS）情况。在2004年至2010年的监测、流行病学和最终结果数据库中，识别出非转移性前列腺癌（T1 - 4N0M0）且Gleason评分8 - 10的患者。这些男性患者按T分期（T1、T2、T3a、T3b - 4）和PSA水平（<4.0 ng/ml、4.0 - 10.0 ng/ml、10.1 - 20.0 ng/ml、>20.0 ng/ml）进行分层。采用倾向得分匹配（PSM）来平衡协变量。进行Kaplan - Meier分析和多变量Cox回归，以分析不同T分期或PSA水平组的PCSS。共识别出33231例年龄为69（62 - 76）岁的患者。总体队列结果显示，T1组的PCSS显著差于T2组和T3a组[T2风险比（HR）：0.62（0.57 - 0.67）；T3风险比：0.70（0.63 - 0.77）]。T2组和T3a组之间无显著差异[T2风险比：0.98（0.91 - 1.05）]。PSA<4.0 ng/ml组的PCSS显著差于PSA 4.0 - 10.0 ng/ml组[PSA 4.0 - 10.0 ng/ml风险比：0.77（0.68 - 0.88）]。在T1与T2、T1与T3a、T2与T3a以及PSA<4.0 ng/ml与PSA 4.0 - 10.0 ng/ml的比较中采用了PSM方法。这些匹配队列的结果显示，T1组的PCSS显著差于T2组[T1风险比：1.31（1.20 - 1.44）]和T3a组[T1风险比：1.33（1.16 - 1.52）]。T2组和T3a组之间无显著差异[T3a风险比：1.14（0.99 - 1.32）]。在匹配队列中，PSA<4.0 ng/ml患者的PCSS显著差于PSA 4.0 - 10.0 ng/ml的患者[PSA<4.0 ng/ml风险比：1.3（1.08 - 1.56）]。对于高分级前列腺癌患者，T1期患者的PCSS似乎比T2期和T3a期患者更差。PSA<4.0 ng/ml的患者预后似乎比PSA 4.0 - 10.0 ng/ml的患者更差。
