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根治性前列腺切除术治疗前局部前列腺癌患者炎性标志物的预后价值。

Prognostic value of pretreatment inflammatory markers in localised prostate cancer before radical prostatectomy.

机构信息

Department of Urology, University Hospital of Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.

出版信息

World J Urol. 2023 Oct;41(10):2693-2698. doi: 10.1007/s00345-023-04569-8. Epub 2023 Sep 25.

Abstract

PURPOSE

There is growing evidence of an association between inflammatory processes and cancer development and progression. In different solid tumor entities, a pronounced inflammatory response is associated with worse oncological outcome. In this study, we aim to evaluate the prognostic role of clinically established pretreatment inflammatory markers in patients with localised prostate cancer (PCa) before radical prostatectomy (RP).

METHODS

A total of 641 men met our inclusion criteria and were followed prospectively for a median of 2.85 years. Univariable logistic and Cox regression analysis were performed to analyse associations between preoperative inflammatory markers and tumor characteristics, and biochemical recurrence free survival (BRFS).

RESULTS

Median age at RP was 64 years. Gleason Score (GS) 7a (263, 41%) was the most prevalent histology, whereas high-risk PCa (≥ GS 8) was present in 156 (24%) patients. Lympho-nodal metastasis and positive surgical margin (PSM) were detected in 69 (11%) and 180 (28%) patients, respectively. No statistically relevant association could be shown between pretreatment inflammatory markers with worse pathological features like higher tumor stage or grade, nodal positive disease or PSM (for all p > 0.05). Additionally, pretreatment inflammatory markers were not associated with a shorter BRFS (p > 0.05). Known risk factors (tumor grade, tumor stage, nodal positivity and positive surgical margins) were all associated with a shorter BRFS (for all p < 0.0001).

CONCLUSION

In this large prospective cohort, preoperative inflammatory markers were not associated with worse outcome.

摘要

目的

越来越多的证据表明炎症过程与癌症的发生和发展有关。在不同的实体肿瘤中,明显的炎症反应与较差的肿瘤学结果相关。在本研究中,我们旨在评估在根治性前列腺切除术(RP)前局部前列腺癌(PCa)患者中临床既定的术前炎症标志物的预后作用。

方法

共有 641 名男性符合我们的纳入标准,并前瞻性随访了中位数为 2.85 年。进行单变量逻辑和 Cox 回归分析,以分析术前炎症标志物与肿瘤特征和生化无复发生存(BRFS)之间的关联。

结果

RP 时的中位年龄为 64 岁。GS 7a(263 例,41%)是最常见的组织学类型,而高危 PCa(≥GS 8)占 156 例(24%)。69 例(11%)和 180 例(28%)患者分别检测到淋巴结转移和阳性手术切缘(PSM)。术前炎症标志物与肿瘤分期或分级较高、淋巴结阳性疾病或 PSM 等较差的病理特征之间没有统计学上的显著关联(所有 p>0.05)。此外,术前炎症标志物与较短的 BRFS 无关(p>0.05)。已知的危险因素(肿瘤分级、肿瘤分期、淋巴结阳性和阳性手术切缘)均与较短的 BRFS 相关(所有 p<0.0001)。

结论

在这个大型前瞻性队列中,术前炎症标志物与不良结局无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5549/10581955/84b74320d73d/345_2023_4569_Fig1_HTML.jpg

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