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诊断时患有转移性激素敏感性前列腺癌的非洲加勒比男性的特征及无进展生存期

Characteristics and progression-free survival of Afro-Caribbean men with metastatic hormone-sensitive prostate cancer at the time of diagnosis.

作者信息

Rossignol Thibault, Gourtaud Gilles, Senechal Cédric, Sadreux Yvane, Roux Virginie, Blanchet Pascal, Brureau Laurent

机构信息

Service d'Urologie, CHU de Pointe-à-Pitre, Pointe-à-Pitre, France.

CHU de Pointe-à-Pitre, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), Pointe-à-Pitre, France.

出版信息

Prostate. 2021 Oct;81(14):1091-1096. doi: 10.1002/pros.24206. Epub 2021 Jul 28.

Abstract

INTRODUCTION AND OBJECTIVES

Metastatic hormone-sensitive prostate cancer (mHSPC) accounts for 12% of prostate cancers diagnosed in Guadeloupe according to the Guadeloupean cancer registry. Most published studies have been conducted on the Caucasian population, whereas data concerning mHSPC in the Afro-Caribbean population are lacking. We aimed to describe the patient characteristics and estimate the progression-free survival of men with mHSPC in an Afro-Caribbean population according to the available treatment.

PATIENTS AND METHODS

This was a monocentric retrospective study that consecutively included 133 men with mHSPC between January 1, 2015 and December 31, 2019 at the University Hospital of Guadeloupe. The primary endpoint was a description of the patients' characteristics with a description of complications at diagnosis. The secondary endpoint was progression-free survival. Kaplan-Meier survival and Cox proportional hazard analyses were performed.

RESULTS

The median age at diagnosis was 71 years. The median prostate-specific antigen (PSA) was 147 ng/ml and 37% of patients presented with a disease-related complication at diagnosis. The survival analysis according to treatment showed median survival of 15 months for the androgen deprivation therapy (ADT) + chemotherapy group, 20 months for the ADT + new hormone therapy group, and 21.5 months for the ADT alone group, with no significant difference between the three therapeutic options (log-rank test: 0.27). In univariate analysis, none of the patient characteristics at diagnosis (i.e., age, PSA, bone lesions, visceral lesions) were significantly associated with the risk of progression, regardless of the treatment.

CONCLUSION

There was no significant difference in terms of progression-free survival between currently validated treatments administered in the first line, regardless of the tumor volume or risk group. Future studies with larger numbers of patients and involving molecular factors are required to confirm or invalidate these results and understand the evolution of prostate cancer in our population and thus better prevent complications related to the disease.

摘要

引言与目的

根据瓜德罗普癌症登记处的数据,转移性激素敏感性前列腺癌(mHSPC)占瓜德罗普岛诊断出的前列腺癌的12%。大多数已发表的研究是针对白种人群进行的,而关于非洲加勒比人群中mHSPC的数据却很缺乏。我们旨在根据可用治疗方法描述非洲加勒比人群中mHSPC男性患者的特征,并估计其无进展生存期。

患者与方法

这是一项单中心回顾性研究,于2015年1月1日至2019年12月31日在瓜德罗普大学医院连续纳入了133例mHSPC男性患者。主要终点是描述患者特征及诊断时的并发症情况。次要终点是无进展生存期。进行了Kaplan-Meier生存分析和Cox比例风险分析。

结果

诊断时的中位年龄为71岁。前列腺特异性抗原(PSA)的中位数为147 ng/ml,37%的患者在诊断时出现与疾病相关的并发症。根据治疗方法进行的生存分析显示,雄激素剥夺治疗(ADT)+化疗组的中位生存期为15个月,ADT+新激素治疗组为20个月,单纯ADT组为21.5个月,三种治疗方案之间无显著差异(对数秩检验:0.27)。在单因素分析中,无论采用何种治疗,诊断时的患者特征(即年龄、PSA、骨转移、内脏转移)均与进展风险无显著相关性。

结论

无论肿瘤体积或风险组如何,一线使用的当前有效治疗方法在无进展生存期方面无显著差异。需要进行更多患者参与且涉及分子因素的未来研究,以证实或否定这些结果,并了解我们人群中前列腺癌的演变情况,从而更好地预防与该疾病相关的并发症。

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