Porcaro Antonio Benito, Serafin Emanuele, Montanaro Francesca, Costantino Sonia, De Bon Lorenzo, Baielli Alberto, Artoni Francesco, Roggero Luca, Brancelli Claudio, Boldini Michele, Bianchi Alberto, Veccia Alessandro, Rizzetto Riccardo, Brunelli Matteo, Cerruto Maria Angela, Bertolo Riccardo Giuseppe, Antonelli Alessandro
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy.
Faculty of Medicine, University of Verona, 37129 Verona, Italy.
J Clin Med. 2024 Dec 31;14(1):193. doi: 10.3390/jcm14010193.
Prostate cancer (PCa) is prevalent among men over 70. Treatment may involve interventions like radical prostatectomy. The objective of this study was to investigate the combination of adverse pathology patterns on PCa progression through the Briganti 2012 nomogram and EAU risk classes in elderly patients treated with robotic surgery. : A cohort of 1047 patients treated from January 2013 to December 2021 was categorized as being older if aged 70 or above. The adverse pathology risk scores were ranked from zero to three. These scores were then analyzed for correlations with the Briganti 2012 nomogram via EAU risk groups and for PCa progression. : Overall, older age was detected in 287 patients who had higher rates of adverse pathology features combined into a pattern risk score of 3. Within each age group, the adverse pathology risk score patterns were positively predicted by the Briganti 2012 nomogram across EAU prognostic groups. After a median (95% CI) follow-up period of 95 months, PCa progression occurred in 237 patients, of whom 68 were elderly and more likely to progress as adverse pathology patterns increased, particularly for a risk score of 3 ( < 0.0001), which was almost three times higher than that in younger patients ( < 0.0001). : Managing PCa in elderly patients is challenging due to their increasing life expectancy. The Briganti 2012 nomogram effectively predicts disease progression in this population. Elderly prostate cancer patients have higher severe pathology rates predicted independently by the Briganti 2012 nomogram, with nearly triple the risk of progression compared to that in younger cases, necessitating tailored treatment approaches.
前列腺癌（PCa）在70岁以上男性中很常见。治疗可能包括根治性前列腺切除术等干预措施。本研究的目的是通过Briganti 2012列线图和欧洲泌尿外科学会（EAU）风险分级，研究老年患者接受机器人手术治疗时不良病理模式与PCa进展的关系。：将2013年1月至2021年12月接受治疗的1047例患者队列中年龄在70岁及以上的患者归类为老年患者。不良病理风险评分从0到3进行排序。然后通过EAU风险组分析这些评分与Briganti 2012列线图的相关性以及与PCa进展的相关性。：总体而言，287例老年患者具有较高的不良病理特征发生率，合并为模式风险评分为3。在每个年龄组中，Briganti 2012列线图在EAU预后组中对不良病理风险评分模式具有正向预测作用。在中位（95%CI）随访期95个月后，237例患者发生PCa进展，其中68例为老年患者，随着不良病理模式增加，进展的可能性更大，尤其是风险评分为3时（<0.0001），几乎是年轻患者的三倍（<0.0001）。：由于老年患者预期寿命增加，管理老年PCa患者具有挑战性。Briganti 2012列线图可有效预测该人群的疾病进展。Briganti 2012列线图独立预测老年前列腺癌患者的严重病理发生率更高，进展风险几乎是年轻患者的三倍，因此需要量身定制治疗方法。
