Luo Zehao, Chi Kaiyi, Zhao Hongjun, Liu Linglong, Yang Wenting, Luo Zhijuan, Liang Yinglan, Zeng Liangjia, Zhou Ruoyun, Feng Manting, Li Yemin, Hua Guangyao, Rao Huying, Lin Xiaozhen, Yi Min
Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China.
Front Cardiovasc Med. 2023 Aug 4;10:1130691. doi: 10.3389/fcvm.2023.1130691. eCollection 2023.
The risk of cardiovascular disease (CVD) mortality in patients with localized prostate cancer (PCa) by risk stratification remains unclear. The aim of this study was to determine the risk of CVD death in patients with localized PCa by risk stratification.
Population-based study of 340,806 cases in the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with localized PCa between 2004 and 2016. The proportion of deaths identifies the primary cause of death, the competing risk model identifies the interaction between CVD and PCa, and the standardized mortality rate (SMR) quantifies the risk of CVD death in patients with PCa.
CVD-related death was the leading cause of death in patients with localized PCa, and cumulative CVD-related death also surpassed PCa almost as soon as PCa was diagnosed in the low- and intermediate-risk groups. However, in the high-risk group, CVD surpassed PCa approximately 90 months later. Patients with localized PCa have a higher risk of CVD-related death compared to the general population and the risk increases steadily with survival (SMR = 4.8, 95% CI 4.6-5.1 to SMR = 13.6, 95% CI 12.8-14.5).
CVD-related death is a major competing risk in patients with localized PCa, and cumulative CVD mortality increases steadily with survival time and exceeds PCa in all three stratifications (low, intermediate, and high risk). Patients with localized PCa have a higher CVD-related death than the general population. Management of patients with localized PCa requires attention to both the primary cancer and CVD.
局部前列腺癌（PCa）患者经风险分层后的心血管疾病（CVD）死亡风险尚不清楚。本研究的目的是通过风险分层确定局部PCa患者的CVD死亡风险。
基于监测、流行病学和最终结果（SEER）数据库中2004年至2016年间诊断为局部PCa的340806例病例进行的人群研究。死亡比例确定主要死因，竞争风险模型确定CVD与PCa之间的相互作用，标准化死亡率（SMR）量化PCa患者的CVD死亡风险。
CVD相关死亡是局部PCa患者的主要死因，在低风险和中风险组中，几乎在PCa确诊后不久，累积CVD相关死亡就超过了PCa。然而，在高风险组中，CVD在大约90个月后超过了PCa。与一般人群相比，局部PCa患者的CVD相关死亡风险更高，且该风险随生存期稳步增加（SMR = 4.8，95% CI 4.6 - 5.1至SMR = 13.6，95% CI 12.8 - 14.5）。
CVD相关死亡是局部PCa患者的主要竞争风险，累积CVD死亡率随生存时间稳步增加，在所有三个分层（低、中、高风险）中均超过PCa。局部PCa患者的CVD相关死亡风险高于一般人群。局部PCa患者的管理需要同时关注原发性癌症和CVD。
