Merrick Gregory S, Rohmann Gabe, Galbreath Robert, Scholl Whitney, Fiano Ryan, Bennett Abbey, Butler Wayne M, Adamovich Edward
Schiffler Cancer Center Urologic Research Institute Wheeling WV USA.
Department of Urology Wheeling Hospital Wheeling WV USA.
BJUI Compass. 2020 Nov 29;2(2):86-91. doi: 10.1002/bco2.52. eCollection 2021 Mar.
To evaluate the impact of age on overall survival (OS), freedom from distant metastasis (FDM), rates of therapeutic intervention (TI), and quality of life (QOL) in active surveillance (AS) prostate cancer patients.
Three hundred and five consecutive, prospectively evaluated AS patients who underwent a staging transperineal template-guided mapping biopsy (TTMB) prior to enrollment on AS were evaluated and stratified by age. Evaluated outcomes included OS, FDM, TI, and QOL to include urinary, bowel, sexual function, and depression. Post void residual (PVR) urine measurements were also followed. Repeat biopsy was based on PSA kinetics, abnormal digital rectal examination or patient preference.
Of the 305 patients, 290 (95.1%) were Gleason 3 + 3 and 15 patients (4.9%) were Gleason 3 + 4. The median follow-up was 5.5 years (range 1-14 years). At 10 years, TI was 0%, 1.0%, and 11.4% for patients ≤59, 60-69, and ≥70 years of age ( < .001). No patient has developed distant metastasis. The median time to TI was 4.71 years. No statistical differences in urinary function, bowel function, or depression were noted. Potency preservation was dependent on patient age.
Within the confines of the follow-up of our series, younger patients were less likely to proceed to therapeutic intervention. In addition, patient age did not adversely impact QOL outcomes.
评估年龄对接受主动监测（AS）的前列腺癌患者的总生存期（OS）、无远处转移生存期（FDM）、治疗干预率（TI）和生活质量（QOL）的影响。
对305例连续的、前瞻性评估的AS患者进行了评估，这些患者在纳入AS之前接受了分期经会阴模板引导穿刺活检（TTMB），并按年龄进行分层。评估的结果包括OS、FDM、TI和QOL，其中QOL包括泌尿、肠道、性功能和抑郁情况。还对排尿后残余（PVR）尿量进行了跟踪。重复活检基于前列腺特异性抗原（PSA）动力学、直肠指检异常或患者偏好。
305例患者中，290例（95.1%）为Gleason 3+3，15例（4.9%）为Gleason 3+4。中位随访时间为5.5年（范围1 - 14年）。在10年时，年龄≤59岁、60 - 69岁和≥70岁患者的TI分别为0%、1.0%和11.4%（P<0.001）。没有患者发生远处转移。TI的中位时间为4.71年。在泌尿功能、肠道功能或抑郁方面未发现统计学差异。性功能保留取决于患者年龄。
在我们系列研究的随访范围内，年轻患者进行治疗干预的可能性较小。此外，患者年龄对生活质量结果没有不利影响。
