Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
Department of Urology, Sorokdo National Hospital, Goheung, South Korea.
Sci Rep. 2021 Sep 22;11(1):18784. doi: 10.1038/s41598-021-98045-1.
There is evidence that a history of benign prostatic hyperplasia increases the incidence of bladder cancer, and treatment with 5-alpha reductase inhibitor or androgen deprivation therapy reduces recurrence of non-muscle invasive bladder cancer. We aimed to evaluate whether prostate volume affects its prognosis. We reviewed medical records of men who underwent transurethral resection of bladder tumor due to non-muscle invasive bladder cancer from January 2012 to December 2017. Patients were divided into two groups based on prostate volume measured by computed tomography (group 1: 264 patients with ≤ 30 mL, group 2: 124 patients with > 30 mL). Propensity score matching analysis was used for adjust selection bias, and then assessed recurrence-free survival and progression-free survival. With a median follow up duration of 52 months, group 1 showed higher 5-year recurrence-free and progression-free survival (69.3% vs 47.0%, p = 0.001; 96.7% vs 87.7%, p = 0.002). Further, cox-regression analysis showed that tumor size (HR = 1.292 p < 0.001), multifocal tumor (HR = 1.993, p < 0.001), adjuvant intravesical therapy (chemotherapy: HR = 0.580, p = 0.037 and bacillus Calmette-Guérin: HR = 0.542, p = 0.004) and prostate volume (HR = 2.326, p < 0.001) were significant predictors of recurrence-free survival. Prostate volume (HR = 2.886, p = 0.014) was also associated with PFS with age (HR = 1.043, p = 0.044) and tumor grade (HR = 3.822, p = 0.013). We conclude higher prostate volume is associated with worse recurrence and progression-free survival in non-muscle invasive bladder cancer.
有证据表明，良性前列腺增生症病史会增加膀胱癌的发病率，而 5-α 还原酶抑制剂或雄激素剥夺疗法治疗可降低非肌层浸润性膀胱癌的复发率。我们旨在评估前列腺体积是否会影响其预后。我们回顾了 2012 年 1 月至 2017 年 12 月期间因非肌层浸润性膀胱癌接受经尿道膀胱肿瘤切除术的男性患者的病历。根据计算机断层扫描测量的前列腺体积将患者分为两组（组 1：264 例前列腺体积≤30ml；组 2：124 例前列腺体积>30ml）。使用倾向评分匹配分析来调整选择偏倚，然后评估无复发生存率和无进展生存率。中位随访时间为 52 个月，组 1 的 5 年无复发生存率和无进展生存率更高（69.3%比 47.0%，p=0.001；96.7%比 87.7%，p=0.002）。此外，cox 回归分析显示肿瘤大小（HR=1.292，p<0.001）、多灶性肿瘤（HR=1.993，p<0.001）、辅助膀胱内治疗（化疗：HR=0.580，p=0.037；卡介苗：HR=0.542，p=0.004）和前列腺体积（HR=2.326，p<0.001）是无复发生存率的显著预测因素。前列腺体积（HR=2.886，p=0.014）也与 PFS 相关（年龄：HR=1.043，p=0.044；肿瘤分级：HR=3.822，p=0.013）。我们得出结论，较高的前列腺体积与非肌层浸润性膀胱癌的复发和无进展生存率较差相关。
