Sayan Mutlay, Tuac Yetkin, Kucukcolak Samet, Rowan Mary D, Pratt Grace K, Aktan Cagdas, Tjio Elza, Akbulut Dilara, Moningi Shalini, Leeman Jonathan E, Orio Peter F, Nguyen Paul L, D'Amico Anthony V, Akgul Mahmut
Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.
Department of Statistics, Ankara University, 06100 Ankara, Türkiye.
Cancers (Basel). 2024 May 14;16(10):1871. doi: 10.3390/cancers16101871.
Given the variable clinical course of prostate cancer and the limitations of current prognostic factors, this study was conducted to investigate the impact of a histologically overt stromal response (HOST-response) to prostate cancer on clinical outcomes after radical prostatectomy.
This retrospective analysis utilized The Cancer Genome Atlas (TCGA) to evaluate data from individuals with a confirmed diagnosis of prostate cancer who underwent radical prostatectomy and had available pathology slides. These slides were assessed for the presence of a HOST-response, similar to desmoplasia. The primary endpoint was progression-free survival (PFS). A multivariable competing risk regression analysis was used to assess whether a significant association existed between HOST-response and PFS, adjusting for known prostate cancer prognostic factors.
Among the 348 patients analyzed, 166 (47.70%) demonstrated a HOST-response. After a median follow-up of 37.87 months (IQR: 21.20, 65.50), the presence of a HOST-response was significantly associated with a shorter PFS (SDHR, 2.10; 95% CI, 1.26 to 3.50; = 0.004), after adjusting for covariates.
HOST-response in prostate cancer patients treated with radical prostatectomy is significantly associated with reduced PFS, suggesting a potential benefit from adjuvant therapy and highlighting the need for further investigation in a prospective randomized clinical trial.
鉴于前列腺癌临床病程的多变性以及当前预后因素的局限性，本研究旨在探讨前列腺癌组织学上明显的基质反应（HOST反应）对根治性前列腺切除术后临床结局的影响。
这项回顾性分析利用癌症基因组图谱（TCGA）评估确诊为前列腺癌且接受了根治性前列腺切除术并有可用病理切片的个体的数据。对这些切片评估是否存在类似于促结缔组织增生的HOST反应。主要终点是无进展生存期（PFS）。采用多变量竞争风险回归分析来评估HOST反应与PFS之间是否存在显著关联，并对已知的前列腺癌预后因素进行校正。
在分析的348例患者中，166例（47.70%）表现出HOST反应。在中位随访37.87个月（四分位间距：21.20，65.50）后，在校正协变量后，HOST反应的存在与较短的PFS显著相关（标准化危险比，2.10；95%置信区间，1.26至3.50；P = 0.004）。
接受根治性前列腺切除术的前列腺癌患者的HOST反应与PFS降低显著相关，提示辅助治疗可能有益，并突出了在前瞻性随机临床试验中进一步研究的必要性。
