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早期,局部性前列腺癌的自然历史
Jan-Erik Johansson1, Ove Andrén, Swen-Olof Andersson
1Department of Urology, Orebro University Hospital, Orebro, Sweden. jan-erik.johansson@orebroll.se
JAMA
|June 10, 2004
概括
早期前列腺癌的长期随访表明,虽然许多病例最初是惰的,但15年后可以发展出侵略性疾病. 这表明早期的激进治疗可能会使预期寿命更长的患者受益.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 流行病学 流行病学
背景情况:
- 了解早期前列腺癌的长期自然史对于确定激进治疗的生存益处至关重要.
- 有限的数据存在于疾病进展和死亡率超过10-15年的警等待队伍.
研究的目的:
- 为了研究未经治疗的前列腺癌早期的长期自然史.
- 在延长的随访期内分析疾病进展和死亡率模式.
主要方法:
- 基于人口的队列研究,平均观察期为21年.
- 包括瑞典中部223名早期 (T0-T2 NX M0) 未经治疗的前列腺癌患者.
- 评估无进展,因特定和整体存活时间.
主要成果:
- 大多数早期的前列腺癌在最初的10-15年内表现出惰的过程.
- 在15年之后,观察到无进展生存率 (45.0%至36.0%) 和前列腺癌特异性生存率 (78.7%至54.4%) 显著下降.
- 15年后,前列腺癌死亡率显著增加 (从每1000人年15人增加到44人).
结论:
- 早期的前列腺癌可以发展为长期的局部进展和侵袭性的转移性疾病.
- 研究结果支持考虑早期激进治疗,特别是对于预计寿命超过15年的患者.
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