在采用低风险前列腺癌主动监测的过程中,患者和环境因素
Giovannino Ciccone1, Stefano De Luca2, Marco Oderda3
1Epidemiologia Clinica e Valutativa, AOU Città della Salute e della Scienza di Torino e CPO Piemonte, Torino, Italy.
JAMA network open
|October 17, 2023
概括
通过研究框架,多学科护理和活检审查,低风险前列腺癌 (LRPC) 采用的积极监测显著增加. 这种方法改善了吸收,但没有影响整体存活率.
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
- 公共卫生 公共卫生
背景情况:
- 建议对低风险前列腺癌 (LRPC) 进行积极监测 (AS),但未得到充分利用.
- 启动了一项以人口为基础的研究,以增加AS采用率并比较结果.
研究的目的:
- 在LRPC患者中实施AS的研究框架.
- 为了比较AS和激进治疗之间的患者特征和临床结果.
主要方法:
- 在意大利西北部进行了一项前性,基于人口的队列研究 (大约. 人口为450万).
- 包括2015年6月至2021年12月期间诊断的LRPC患者.
- 从2023年1月到5月的数据分析,将AS与激进前列腺切除术 (RP) 或放射治疗 (RT) 进行比较.
主要成果:
- 在852名LRPC患者中,82.9%选择了AS,随着时间的推移显示出越来越大的趋势.
- 年龄较大,并发病率较高,独立的活检审查和多学科评估与更高的AS吸收有关.
- 在AS和激进治疗之间没有观察到总生存时间的显著差异.
结论:
- 一个系统层面的研究框架,患者层面的因素 (预后因素,多学科方法,活检审查) 和中心特定的治疗选择显著增加了对LRPC的AS采用.
- 本研究展示了一种成功的策略,以克服AS实施的障碍.
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