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针对MRI的前列腺活检引入了等级膨胀和过度治疗

Abderrahim Oussama Batouche^1,2,3, Eugen Czeizler^1,3, Timo-Pekka Lehto^1,3

¹Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland.

medRxiv : the preprint server for health sciences

|January 23, 2024

概括

针对MRI的活检可能导致过度治疗格里森等级2组 (GG2) 前列腺癌. 通过MRI向活检检测到的GG2癌症患者的复发风险与GG1前列腺癌患者的复发风险相似,这表明需要更新指南.

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.
放射学放射学是一门学科.

背景情况:

针对MRI的活检检测出较少的格里森等级1组 (GG1) 和更多的GG2前列腺癌.
这种转变可能是由于MRI灵敏度提高或等级膨胀.

研究的目的:

为了比较最终治疗的可能性和治疗后复发的风险.
为了评估患有GG2癌症 (向活检) 和GG1癌症 (系统活检) 的患者.

主要方法:

使用第三级中心注册 (1993-2019) 的回顾性研究.
包括3317名GG1 (系统活检) 和554名GG2 (向活检) 的男性.
评估治疗治疗风险和治疗后复发,使用卡普兰-梅尔曲线和考克斯回归.

主要成果:

与GG1癌症 (系统活检) 的患者相比,与GG2癌症 (向活检) (4个月) 相比,GG1癌症 (系统活检) 的患者的治疗时间中位数 (31个月) 显著更长.
治疗后复发的风险在两组之间是相似的 (HR:0.94,95% CI [0.71-1.25]).

结论:

来自MRI向活检的GG2癌症的治疗比系统活检的GG1癌症更为积极,尽管瘤风险相似.
更新治疗指南是必要的,以解决诊断途径的变化,并防止过度治疗.

关键词:

磁共振成像技术磁共振成像技术新生体分类新生体分类复发情况复发情况幸存的生存方式一个警的等待.

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