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激进前列腺切除术与临床局部前列腺癌的种子支臂治疗的结果比较,使用两个生化复发定义
Xue-Hua Zhu1,2, Fan Zhang1, Ze-Nan Liu1
1Department of Urology, Peking University Third Hospital, Beijing, China.
BMC surgery
|August 27, 2023
概括
激进的前列腺切除术 (RP) 和种子支臂疗法 (BT) 在使用Phoenix生物化学复发 (BCR) 定义时,为局部前列腺癌提供了可比的结果. 然而,RP显示了更好的BCR无生存与手术定义.
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
- 辐射瘤学 辐射瘤学
背景情况:
- 激进前列腺切除术 (RP) 和种子支臂疗法 (BT) 是临床局部前列腺癌 (LPCa) 的主要治疗方法.
- 生物化学复发 (BCR) 是一个关键的结果指标,但定义可能会有所不同.
- 准确的预后评估依赖于一致的BCR定义.
研究的目的:
- 为了比较LPCa的RP与BT的结果.
- 评估两个不同的BCR定义对治疗比较的影响.
- 为了评估RP和BT之间的BCR无生存 (BFS),使用倾向性得分匹配 (PSM).
主要方法:
- 对1117名非转移性前列腺癌患者的回顾性分析,这些患者接受了RP或BT治疗.
- 包括843名LPCa患者在治疗后的前列腺特异抗原 (PSA) 数据.
- 使用手术 (PSA ≥0.2 ng/ml) 和 (PSA nadir + 2 ng/ml) 的定义,评估BCR存活率,有或没有PSM.
主要成果:
- 使用Phoenix定义,RP和BT之间的BFS没有显著差异 (P > 0.05).
- 与BT相比,RP在整个队列和PSM后使用手术定义显著改善了BFS (P <0.05).
- 跨达米科风险组的分层分析显示了类似的趋势.
结论:
- 没有BCR的生存结果是不一致的,这取决于用于BT的定义.
- RP提供与BT相似的BFS,具有城定义,但具有更优质的BFS,具有外科定义.
- 选择BCR定义对于精确的预后评估和前列腺癌管理中的治疗选择至关重要.
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