Brasso K, Friis S, Juel K, Jørgensen T, Iversen P
Department of Urology, Rigshospitalet, Copenhagen, Denmark.
J Urol. 1999 Feb;161(2):524-8.
We studied the outcome in patients with early and probably organ confined prostate cancer who were considered candidates for curative therapy and treated expectantly.
The study included 2,570 patients with newly diagnosed prostate cancer reported to the Danish Cancer Registry from 1943 to 1986 and surviving for 10 years or longer. Mortality and causes of death were analyzed and stratified by stage, age and time of diagnosis. Excess mortality was calculated from life expectancy tables for the general population.
An overall excess mortality (standard mortality ratio 1.58, 95% confidence interval [95% CI] 1.51 to 1.65) was found. Young age and advanced clinical stage at diagnosis entailed a higher risk of death from prostate cancer. Overall 42.7 and 19.1% of the patients who died had prostate cancer as the direct or contributing cause of death, respectively. Of the annual deaths 13% were attributable to prostate cancer. In 1,326 patients 55 to 64 and 65 to 74 years old with clinically localized prostate cancer at diagnosis the excess mortality was still significant (standard mortality ratio 1.72, 95% CI 1.54 to 1.93 and 1.50, 95% CI 1.39 to 1.62, respectively). Prostate cancer was the primary or contributing cause of death in 42.9% of the younger group and 21.5% of the older group. In these patients 15% of the annual deaths were related to prostate cancer.
Patients with clinically localized prostate cancer for 10 years or longer, who were likely candidates for curative therapy when diagnosed, had significant excess mortality when treated expectantly.
我们研究了早期且可能局限于器官的前列腺癌患者的预后，这些患者被视为根治性治疗的候选者并接受了观察等待治疗。
该研究纳入了1943年至1986年向丹麦癌症登记处报告的2570例新诊断的前列腺癌患者，且这些患者存活了10年或更长时间。按分期、年龄和诊断时间对死亡率及死亡原因进行分析和分层。根据一般人群的预期寿命表计算超额死亡率。
发现总体超额死亡率（标准化死亡率比为1.58，95%置信区间[95%CI]为1.51至1.65）。诊断时年龄较轻和临床分期较晚导致前列腺癌死亡风险更高。总体而言，死亡患者中分别有42.7%和19.1%的患者前列腺癌为直接或促成死亡原因。每年的死亡病例中有13%归因于前列腺癌。在1326例诊断时患有临床局限性前列腺癌的55至64岁和65至74岁患者中，超额死亡率仍然显著（标准化死亡率比分别为1.72，95%CI为1.54至1.93；以及1.50，95%CI为1.39至1.62）。前列腺癌是较年轻组42.9%患者和较年长组21.5%患者的主要或促成死亡原因。在这些患者中，每年15%的死亡与前列腺癌有关。
临床局限性前列腺癌患者若诊断后观察等待治疗10年或更长时间，且诊断时可能是根治性治疗的候选者，其超额死亡率显著。
