Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.
Biostatistical Department, Institut Paoli-Calmettes, Marseille, France.
Clin Genitourin Cancer. 2021 Aug;19(4):346-353. doi: 10.1016/j.clgc.2021.03.004. Epub 2021 Mar 16.
Choline positron emission tomography/computed tomography (PET/CT) is a new imaging technique for the detection of oligometastatic (OM) prostate cancer. The aim of this study was to evaluate the outcomes after initial OM diagnoses; treatment, particularly metastasis-directed therapy (MDT); and determine risk groups.
This multi-center, retrospective study included patients with hormone-sensitive biological relapse after local treatment with curative intent and with fewer than six choline PET/CT metastases. The primary endpoint was biochemical relapse-free survival (bRFS). Risk groups were based on prostate-specific antigen (PSA) ≥ 0.8 ng/mL and metastatic sites at OM cancer diagnosis.
Between October 2012 and December 2016, 177 patients were included, with a median follow-up of 49.02 months. The median bRFS was 39.74 months. In multivariate analyses, bone metastases and PSA ≥ 0.8 ng/mL were associated with worse bRFS. Four risk groups (I to IV; hazard ratio [HR], 5.92; 95% confidence interval [CI], 1.32-26.61) were observed, with median bRFS not reached for group I (PSA < 0.8 ng/mL; node metastasis [M1a]), a 40.00-month bRFS for group II (PSA ≥ 0.8 ng/mL; M1a), 29.97-month bRFS for group III (bone metastasis [M1b], whatever the PSA level); and 22.70-month bRFS for group IV (PSA > 0.8 ng/mL and visceral metastasis [M1c]). MDT plus androgen deprivation therapy (ADT) improved bRFS over MDT alone (48.36 vs. 34.16 months; HR, 2.12; 95% CI, 1.38-3.26), particularly for group II (HR, 2.09; 95% CI, 1.09-4.00), and reached a limit of significance for group III (HR, ;3.79 95% CI, 0.88- 16.38).
Prognostic group classifications were confirmed: PSA < 0.8 ng/mL and M1a showed a better outcome than patients with M1c and PSA ≥ 0.8 ng/mL. These results could facilitate patient selection for prospective clinical trials in OM prostate cancer.
胆碱正电子发射断层扫描/计算机断层扫描（PET/CT）是一种用于检测寡转移性（OM）前列腺癌的新成像技术。本研究的目的是评估初始 OM 诊断后的结果；治疗，特别是针对转移灶的治疗（MDT）；并确定风险组。
这项多中心、回顾性研究纳入了局部治疗后具有生物复发且少于 6 个胆碱 PET/CT 转移灶的激素敏感型前列腺癌患者。主要终点是生化无复发生存（bRFS）。风险组基于前列腺特异性抗原（PSA）≥0.8ng/mL 和 OM 癌症诊断时的转移部位。
2012 年 10 月至 2016 年 12 月期间，共纳入 177 例患者，中位随访时间为 49.02 个月。中位 bRFS 为 39.74 个月。多变量分析显示，骨转移和 PSA≥0.8ng/mL 与 bRFS 较差相关。观察到 4 个风险组（I 至 IV；风险比[HR]，5.92；95%置信区间[CI]，1.32-26.61），I 组（PSA<0.8ng/mL；淋巴结转移[M1a]）的中位 bRFS 未达到，II 组（PSA≥0.8ng/mL；M1a）的 bRFS 为 40.00 个月，III 组（骨转移[M1b]，无论 PSA 水平如何）的 bRFS 为 29.97 个月，IV 组（PSA>0.8ng/mL 和内脏转移[M1c]）的 bRFS 为 22.70 个月。MDT 加雄激素剥夺治疗（ADT）改善了 bRFS，优于单独 MDT（48.36 对 34.16 个月；HR，2.12；95%CI，1.38-3.26），特别是对 II 组（HR，2.09；95%CI，1.09-4.00），对 III 组达到了显著水平（HR，；3.79 95%CI，0.88-16.38）。
证实了预后分组分类：PSA<0.8ng/mL 和 M1a 比 M1c 和 PSA≥0.8ng/mL 的患者具有更好的结果。这些结果可以促进 OM 前列腺癌患者选择前瞻性临床试验。
Zotero 插件