西班牙前列腺癌主动监测的真实世界证据；中期结果。

Real World Evidence of Active Surveillance for Prostate Cancer in Spain; Midterm Results.

作者信息

Rubio-Briones J, Borque-Fernando A, Esteban Escaño L M, Wong A, Guijarro Cascales A, Gómez Gómez E, Gil Fabra J M, Sanguedolce F, Gomez-Veiga F, López González P A, Plata Bello A, Rodríguez García N, Montesino Semper M, Suárez Novo J F, Hajianfar R, Fumadó Ciutat L L, González Alfaro A, Duarte Ojeda J M, Bono Ariño A, Quicios Dorado C, Loizaga Iriarte A, García Fadrique G, Giménez Bachs J M, García Barreras S, Pallas Costa Y, Vilaseca Cabo A, Rodrigo Aliaga M, Campanario Pérez F, Servián P, Campá Bortoló J M, Soto Delgado M, Rodríguez de Ledesma J M, Sánchez Rodríguez C, Chantada Abal V, Hernández Martínez Y E, Herrera Imbroda B, Dolezal P, Gual Frau J, Medrano Llorente P, Moreno Jiménez J, Serrano Uribe J S, Congregado Ruiz C B, Reyes A, Fernández Aparicio T, García Rodríguez J, Cuadras Solé M, García Seguí A, Pacheco Bru J J, Mayor de Castro J, Mira Moreno A, Molina Suárez J L

机构信息

Hospital VITHAS 9 de Octubre, Valencia, Spain.

Hospital Miguel Servet, IIS-Aragon, Zaragoza, Spain.

出版信息

Cancer Med. 2025 Sep;14(17):e71173. doi: 10.1002/cam4.71173.

DOI:10.1002/cam4.71173

PMID:40926355

Abstract

PATIENTS AND METHODS

In this multicenter longitudinal study, data from the Spanish Register in AS (AEU-PIEM/2014/0001) were reviewed. The study focused on a cohort of AS patients registered between 2014 and 2019, featuring open inclusion criteria and diverse follow-up strategies.

RESULTS

A total of 3315 AS patients were recruited, with 2881 and 434 categorized into the low and intermediate risk groups based on NCCN grouping at inclusion. The median age was 67 years, and only 11% underwent diagnostic biopsy guided by MRI. The median time between follow-up visits was 6.03 months. Over a median follow-up of 62 months (Q1-3: 43.78-85.58), 37% remained in AS, while 8% transitioned to watchful waiting due to aging or intercurrent disease. Death occurred in 199 (6%) of patients, with 3 due to prostate cancer progression and 196 attributed to other causes. At 2 and 5 years, pathological progression-free survival, metastasis-free survival, and active treatment-free survival were 68% and 51%, 99% and 99%, and 70% and 50%, respectively.

CONCLUSIONS

Midterm oncological outcomes of AS in Spain align with major international series. We denote underuse of guideline recommendations such as use of MRI or TP Bx for initial PCa characterization. Collaborative efforts are crucial in the search for algorithms, new imaging, or biomarkers to refine indications and transition to active treatments.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02865330.

摘要

患者与方法

在这项多中心纵向研究中，对西班牙强直性脊柱炎登记处（AEU - PIEM/2014/0001）的数据进行了回顾。该研究聚焦于2014年至2019年登记的一组强直性脊柱炎患者，纳入标准开放且随访策略多样。

结果

共招募了3315例强直性脊柱炎患者，根据纳入时的NCCN分组，2881例和434例分别归入低风险和中风险组。中位年龄为67岁，仅11%的患者在MRI引导下进行了诊断性活检。随访就诊之间的中位时间为6.03个月。在中位随访62个月（第一四分位数 - 第三四分位数：43.78 - 85.58）期间，37%的患者仍处于强直性脊柱炎状态，而8%的患者因年龄增长或并发疾病转为观察等待。199例（6%）患者死亡，其中3例死于前列腺癌进展，196例归因于其他原因。在2年和5年时，无病理进展生存率、无转移生存率和无积极治疗生存率分别为68%和51%、99%和99%、70%和50%。