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前立腺 がん: 概要

Ruben Raychaudhuri1,2, Daniel W Lin3,2, R Bruce Montgomery1,2,4

  • 1Department of Medicine, University of Washington, Seattle.

JAMA
|March 10, 2025
PubMed
まとめ

前立腺がんは男性に多く見られるがんで,局所的な疾患の生存率は高い. アンドロゲン受容体経路阻害剤を含む先進的な前立腺がん治療は,転移した症例の生存結果を改善します.

科学分野:

  • 腫瘍学
  • 泌尿器科
  • 癌 研究

背景:

  • 前立腺がんは米国男性で最も一般的な非皮膚癌で 世界的に2番目に多い癌です
  • リスク要因には,遺伝,高齢化,黒人人種が含まれ,スクリーニングの共有意思決定が奨励されます.
  • 局所性前立腺がんの5年生存率はほぼ100%で 転移性疾患の5年生存率は37%です

研究 の 目的:

  • 前立腺がんの流行病学,危険因子,治療戦略の現在の理解を要約する.
  • 局所的および転移性前立腺がんの管理における進歩を強調する.
  • スクリーニング,アクティブ・サーベイランス,治療の選択肢に関する臨床的意思決定に情報を提供すること.

主な方法:

  • 前立腺がんの発生率と死亡率に関する疫学データのレビュー
  • 遺伝的傾向と人口統計学的変数を含むリスク要因の分析
  • 局所性および転移性前立腺がんの治療方法の評価,積極的な監視,手術,放射線治療,アンドロゲン欠乏療法,および新薬を含む.

主要な成果:

  • 2024年と2022年には,アメリカでは29万9000人,世界では140万人が新たに感染すると推定されています.
  • 局所的な疾患は約75%で,転移性疾患は10%である.

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  • アビラテロンなどの新しいアンドロゲン受容体経路阻害剤は,転移性前立腺がん患者の全生存率を大幅に改善します.
  • 結論:

    • 前立腺がんの管理は,疾患の段階とリスクの階層化によって異なります.
    • 局所的な症例の3分の1に積極的な監視が適しており,放射線治療や前立腺切除はリスクの高い疾患の選択肢です.
    • アンドロゲン受容体経路阻害剤や化学療法と併用したアンドロゲン欠乏療法が,転移性前立腺がんの標準治療である.