Maddah Mohammad Moein, Hedayatizadeh-Omran Akbar, Moosazadeh Mahmood, Alizadeh-Navaei Reza
Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Science, Sari, Iran.
Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Science, Sari, Iran.
Clin Genitourin Cancer. 2024 Dec;22(6):102226. doi: 10.1016/j.clgc.2024.102226. Epub 2024 Sep 14.
Prostate cancer, 1 of the most common cancers in men, is influenced by age, genetics, race, and lifestyle. The TP53 gene, encoding the p53 protein crucial for cell cycle regulation and DNA repair, is frequently mutated in metastatic prostate cancers. These mutations impact prognosis and resistance to treatments, underscoring the role of genetic factors in disease progression and therapeutic challenges.
Databases such as PubMed, Scopus, and ISI were searched using the keywords "prostate cancer," "P53," "TP53," "survival," and "prognosis," along with manual searches in other sources. Initial screening and selection of articles were conducted independently and blinded by 2 reviewers, focusing on titles abstracts, and full texts when necessary. The Newcastle-Ottawa Scale (NOS) was used for full-text evaluation. Data were analyzed using STATA 11, with heterogeneity assessed using the I² index.
Overall survival (OS) for prostate cancer patients with TP53 mutations was approximately 13% lower than for those without mutations at 1 year, 20% lower at 3 years, and 16% lower at 5 years. TP53 mutations were also associated with faster disease progression and a 15% reduction in progression-free survival (PFS) over 1 year. The hazard ratio (HR) for death in patients with TP53 mutations was 1.76, and for PFS, it was 1.62, indicating a 76% increased risk of death and a 62% increased risk of disease progression.
TP53 mutations are associated with shorter survival and faster disease progression in prostate cancer, underscoring the importance of precise evaluation and management of these mutations in treatment.
前列腺癌是男性最常见的癌症之一，受年龄、遗传、种族和生活方式影响。编码对细胞周期调控和DNA修复至关重要的p53蛋白的TP53基因，在转移性前列腺癌中经常发生突变。这些突变影响预后和对治疗的抗性，凸显了遗传因素在疾病进展和治疗挑战中的作用。
使用关键词“前列腺癌”“P53”“TP53”“生存”和“预后”检索PubMed、Scopus和ISI等数据库，并在其他来源进行人工检索。由2名评审员独立且盲法进行文章的初步筛选和选择，必要时关注标题、摘要和全文。使用纽卡斯尔-渥太华量表（NOS）进行全文评估。使用STATA 11分析数据，使用I²指数评估异质性。
TP53突变的前列腺癌患者的总生存期（OS）在1年时比未突变患者低约13%，3年时低20%，5年时低16%。TP53突变还与疾病进展更快相关，1年内无进展生存期（PFS）降低15%。TP53突变患者的死亡风险比（HR）为1.76，PFS的HR为1.62，表明死亡风险增加76%，疾病进展风险增加62%。
TP53突变与前列腺癌患者生存期缩短和疾病进展更快相关，凸显了在治疗中对这些突变进行精确评估和管理的重要性。
