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在急性前列腺切除术后PSA升高后,自然进展史

C R Pound¹, A W Partin, M A Eisenberger

¹Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, MD 21287-2101, USA.

|May 11, 1999

概括

在前列腺切除术后PSA升高的男性可以在复发8年后发展转移. 临床因素,如格里森评分预测进展,告知前列腺癌患者的治疗和临床试验设计.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
在瘤学瘤学.
医学统计医学统计

背景情况:

在急性前列腺切除术后前列腺癌复发可能表现为前列腺特异抗原 (PSA) 的升高.
在这些患者中,疾病进展的自然史,包括转移和死亡,仍然不太清楚.

研究的目的:

在激进前列腺切除术后经历生化复发的男性中,描述疾病进展的时间进程.
为了确定转移性疾病发展和生存结果的预测因素.

主要方法:

对1997年因局部性前列腺癌接受激进前列腺切除术的男性进行了回顾性审查.
随访包括PSA测定,数字直肠检查和成像检测转移.
使用生存分析来确定进展和死亡的预测因素.

主要成果:

15%的男性发生了生化复发 (PSA升高).
在复发患者中,34%的人患上转移性疾病,PSA升高后转移的中位时间为8年.
生物化学进展的时间,格里森得分和PSA翻倍时间预测了转移性发展;转移的时间预测了生存.

结论:

临床参数,如PSA进展的时间,格里森得分和PSA翻倍时间,可以预测前列腺切除术后PSA升高的男性的结果.
这些发现有助于设计临床试验,确定患者队列,并就辅助治疗时间进行咨询.

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