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接受开放性、腹腔镜或机器人辅助根治性前列腺切除术的患者在手术切缘阳性率或无生化复发生存率方面无差异:一项来自国家癌症数据库的全国性队列研究。

There Are No Differences in Positive Surgical Margin Rates or Biochemical Failure-Free Survival among Patients Receiving Open, Laparoscopic, or Robotic Radical Prostatectomy: A Nationwide Cohort Study from the National Cancer Database.

作者信息

Chang Shyh-Chyi, Chen Ho-Min, Wu Szu-Yuan

机构信息

Department of Urology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.

Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei 11221, Taiwan.

出版信息

Cancers (Basel). 2020 Dec 31;13(1):106. doi: 10.3390/cancers13010106.

Abstract

: To estimate the rates of positive surgical margin (PSM) and biochemical failure-free survival (BFS) among patients with prostate cancer (PC) receiving open, laparoscopic, or robotic radical prostatectomy (RP). : The patients were men enrolled in the Taiwan Cancer Registry diagnosed as having PC without distant metastasis who received RP. After adjustment for confounders, logistic regression was used to model the risk of PSM following RP. After adjustment for confounders, Cox proportional regression was used to model the time from the index (i.e., surgical) date to biochemical recurrence. : The adjusted odds ratios (95% CIs) of PSM risk after propensity score adjustment for laparoscopic versus open, robotic versus open, and robotic versus laparoscopic RP 95% CIs were 1.25 (0.88 to 1.77; = 0.2064), 1.16 (0.88 to 1.53; = 0.2847), and 0.93 (0.70 to 1.24; = 0.6185), respectively. The corresponding adjusted hazard ratios (95% CIs) of risk of biochemical failure after propensity score adjustment were 1.16 (0.93 to 1.47; = 0.1940), 1.10 (0.83 to 1.47; = 0.5085), and 0.95 (0.74 to 1.21; = 0.6582). : No significant differences in PSM or BFS were observed among patients receiving open, laparoscopic, or robotic RP.

摘要

评估接受开放性、腹腔镜或机器人辅助根治性前列腺切除术(RP)的前列腺癌(PC)患者的手术切缘阳性(PSM)率和无生化复发生存率(BFS)。

研究对象为台湾癌症登记处登记的被诊断为PC且无远处转移并接受RP的男性患者。在对混杂因素进行调整后,采用逻辑回归对RP术后PSM的风险进行建模。在对混杂因素进行调整后,采用Cox比例回归对从索引日期(即手术日期)到生化复发的时间进行建模。

倾向评分调整后,腹腔镜与开放性、机器人辅助与开放性、机器人辅助与腹腔镜RP的PSM风险调整后的优势比(95%CI)分别为1.25(0.88至1.77;P = 0.2064)、1.16(0.88至1.53;P = 0.2847)和0.93(0.70至1.24;P = 0.6185)。倾向评分调整后生化失败风险的相应调整后风险比(95%CI)分别为1.16(0.93至1.47;P = 0.1940)、1.10(0.83至1.47;P = 0.5085)和0.95(0.74至1.21;P = 0.6582)。

接受开放性、腹腔镜或机器人辅助RP的患者在PSM或BFS方面未观察到显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cde/7795659/fc43948992e1/cancers-13-00106-g001.jpg

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