Siech Carolin, de Angelis Mario, Jannello Letizia Maria Ippolita, Di Bello Francesco, Rodriguez Peñaranda Natali, Goyal Jordan A, Tian Zhe, Saad Fred, Shariat Shahrokh F, Puliatti Stefano, Longo Nicola, de Cobelli Ottavio, Briganti Alberto, Wenzel Mike, Mandel Philipp, Kluth Luis A, Chun Felix K H, Karakiewicz Pierre I
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Int J Cancer. 2025 Jun 15;156(12):2311-2319. doi: 10.1002/ijc.35323. Epub 2024 Dec 30.
Survival differences in rare histological prostate cancer (PCa) subtypes relative to age-matched population-based controls are unknown. Within Surveillance, Epidemiology, and End Results database (2004-2020), newly diagnosed (2004-2015) PCa patients were identified. Relying on the Social Security Administration Life Tables (2004-2020) with 5 years of follow-up, age-matched population-based controls (Monte Carlo simulation) were simulated for each patient. Kaplan-Meier analyses addressed survival rates. Of 582,220 patients, 580,368 (99.68%) harbored acinar, 867 (0.15%) ductal, 534 (0.09%) neuroendocrine, 368 (0.07%) mucinous, and 83 (0.01%) signet ring cell carcinoma. The metastatic stage was most prevalent in neuroendocrine (62%). In the localized stage, the overall survival difference at 5 years of follow-up was greatest in neuroendocrine (22% vs. 72%), signet ring cell (78% vs. 84%), and ductal carcinoma (71% vs. 77%). In the locally advanced stage, overall survival difference was greatest in neuroendocrine (16% vs. 79%), signet ring cell (75% vs. 91%), ductal (78% vs. 84%), and mucinous carcinoma (84% vs. 90%). In the metastatic stage, the overall survival difference was greatest in neuroendocrine (3% vs. 81%), mucinous (26% vs. 84%), and acinar carcinoma (27% vs. 85%). Regardless of stage, neuroendocrine carcinoma patients exhibit the least favorable life expectancy compared with population-based controls. Conversely, all other rare histological PCa subtypes do not meaningfully affect life expectancy in localized or locally advanced stages, except for locally advanced signet ring cell adenocarcinoma.
相对于年龄匹配的基于人群的对照，罕见组织学类型前列腺癌（PCa）亚型的生存差异尚不清楚。在监测、流行病学和最终结果数据库（2004 - 2020年）中，识别出2004 - 2015年新诊断的PCa患者。利用社会保障管理局生命表（2004 - 2020年）并进行5年随访，为每位患者模拟年龄匹配的基于人群的对照（蒙特卡洛模拟）。采用Kaplan - Meier分析计算生存率。在582,220例患者中，580,368例（99.68%）为腺泡癌，867例（0.15%）为导管癌，534例（0.09%）为神经内分泌癌，368例（0.07%）为黏液癌，83例（0.01%）为印戒细胞癌。转移期在神经内分泌癌中最为常见（62%）。在局限性阶段，随访5年时总体生存差异在神经内分泌癌（22%对72%）、印戒细胞癌（78%对84%）和导管癌（71%对77%）中最大。在局部晚期阶段，总体生存差异在神经内分泌癌（16%对79%）、印戒细胞癌（75%对91%）、导管癌（78%对84%）和黏液癌（84%对90%）中最大。在转移期，总体生存差异在神经内分泌癌（3%对81%）、黏液癌（26%对84%）和腺泡癌（27%对85%）中最大。无论处于何阶段，与基于人群的对照相比，神经内分泌癌患者的预期寿命最不理想。相反，除局部晚期印戒细胞腺癌外，所有其他罕见组织学类型的PCa亚型在局限性或局部晚期阶段对预期寿命无显著影响。
