偶发性前列腺癌的其他原因死亡率
Francesco Di Bello1,2, Andrea Baudo1,3,4, Mario de Angelis1,5,6
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
The Prostate
|March 20, 2024
概括
其他原因死亡率 (OCM) 在未接受主动治疗的偶发性前列腺癌 (IPCa) 患者中明显超过癌症特异性死亡率 (CSM). 这一发现支持选择性IPCa病例的保守管理,其中OCM风险更高.
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.
- 流行病学 流行病学
背景情况:
- 在偶发性前列腺癌 (IPCa) 中增加的其他原因死亡率 (OCM) 可能会否定积极治疗的需要.
- 在IPCa中OCM率因治疗方法和癌症等级而异.
- 假设:OCM在没有接受活性治疗的患者中明显高.
研究的目的:
- 在偶发性前列腺癌患者中量化OCM率.
- 根据积极治疗状态和癌症等级来比较OCM.
- 确定OCM是否在未经治疗的IPCa.中超过癌症特异性死亡率 (CSM).
主要方法:
- 对监测,流行病学和最终结果数据库 (2004-2015) 的分析.
- 鉴定偶发性前列腺癌 (IPCa) 患者.
- 应用平滑的累积发病率图和多变量竞争性风险回归模型,调整为CSM.
主要成果:
- 在5121名IPCa患者中,71%没有接受活性治疗.
- 五年后的OCM为不积极治疗的患者的20%,而积极治疗的患者为8%.
- 没有活性治疗与高出1.4倍的OKM相关,不论年龄,癌症特征和CSM.
结论:
- 与积极治疗患者相比,在不积极治疗的IPCa患者中,OCM显着更高 (HR: 1.4).
- 在未经处理的IPCa (20%) 中,OCM的发病率大大超过CSM (5%),支持保守的管理.
- 结果验证了IPCa患者没有活性治疗的策略,其中OCM风险占主导地位.
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