高危前列腺癌中根治性前列腺切除术与外照射放疗的比较。
Comparison of radical prostatectomy and external beam radiotherapy in high-risk prostate cancer.
作者信息
Sangthong Peerapon, Binsri Nattapong, Kanjanatarayon Sarayut, Wiriyabanditkul Weerayut, Pattanasuwon Thanisorn, Siriboonrid Satit
机构信息
Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand.
出版信息
Urol Ann. 2025 Jul-Sep;17(3):144-148. doi: 10.4103/ua.ua_21_25. Epub 2025 Jul 18.
PURPOSE
We evaluated the clinical outcome of high-risk prostate cancer patients receiving radical prostatectomy (RP) or radiotherapy (RT).
MATERIALS AND METHODS
Patients were classified as high-risk prostate cancer and received definitive treatment between 2013 and 2023. Patients with previous pelvic RT and incomplete medical record were excluded. The primary outcomes were progression-free survival (PFS) and distant metastasis-free survival (MFS). The secondary outcomes were factors for progression and metastasis.
RESULTS
Of 244 patients analyzed (89 RP and 155 RT); the estimated 10-year PFS was 49.9% in the RP and 75.5% in the RT ( = 0.013). No significant difference was seen in the distant MFS ( = 0.177) and overall survival ( = 0.052). Univariate and multivariate were analyzed; the factor for progress or metastasis was initial prostate-specific antigen.
CONCLUSION
Our data demonstrated that RT offers superiority over RP in PFS, whereas distant metastasis was similar.
目的
我们评估了接受根治性前列腺切除术（RP）或放射治疗（RT）的高危前列腺癌患者的临床结局。
材料与方法
患者被归类为高危前列腺癌，并在2013年至2023年期间接受了确定性治疗。排除既往有盆腔放疗史和病历不完整的患者。主要结局是无进展生存期（PFS）和无远处转移生存期（MFS）。次要结局是进展和转移的因素。
结果
在分析的244例患者中（89例行RP，155例行RT）；RP组估计的10年PFS为49.9%，RT组为75.5%（P = 0.013）。远处MFS（P = 0.177）和总生存期（P = 0.052）未见显著差异。进行了单因素和多因素分析；进展或转移的因素是初始前列腺特异性抗原。
结论
我们的数据表明，在PFS方面，RT优于RP，而远处转移情况相似。
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