针对前列腺癌风险适当治疗的临床和功能结果
Tenaw Tiruye1,2, Michael O'Callaghan3,4,5,6, Kerry Ettridge7,8
1Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance University of South Australia Adelaide Australia.
BJUI compass
|January 5, 2024
概括
现实世界的数据显示,在不同治疗方法中,局部性前列腺癌的生存率很高. 激进的前列腺切除术导致了更多的功能衰退,而积极的监测为低风险患者提供了很好的结果.
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
- 临床结果研究研究
背景情况:
- 局部性前列腺癌的治疗决策是复杂的,平衡有效性与功能结果.
- 现实世界的数据对于了解临床试验之外的长期结果至关重要.
- 风险分层是指导适当的前列腺癌管理的关键.
研究的目的:
- 评估澳大利亚男性局部前列腺癌的现实世界临床和功能结果.
- 根据治疗方式 (根性前列腺切除术,放射治疗,积极监测) 和风险类别来比较结果.
- 提供关于前列腺癌护理的知情治疗决策的证据.
主要方法:
- 来自南澳大利亚前列腺癌临床结果协作注册表 (2008-2018) 的前性数据收集.
- 包括8513名被诊断患有局部性前列腺癌的男性.
- 使用多变量模型分析整体存活率,癌症特异性存活率,功能衰退,生化复发和积极治疗过渡.
主要成果:
- 在低风险和中等风险类别中观察到高的5年总生存率 (>91%) 和癌症特异性生存率 (>97%).
- 激进性前列腺切除术 (RP) 和外部束辐射疗法 (带或不带雌激素剥夺疗法 (EBRT +/- ADT)) 显示出不同的功能影响.
- 积极监测表明100%的5年癌症特异性存活率;15-20%在2年内过渡到积极治疗.
结论:
- 当代现实世界的证据支持局部前列腺癌的良好生存结果.
- 治疗选择显著影响功能结果,RP与更大的尿 / 性衰退相关,EBRT +/- ADT与更多的肠道问题相关.
- 适当的风险治疗和积极的监测对于优化患者的治疗结果和为临床决策提供信息至关重要.
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