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对于中等风险前列腺癌男性的积极监测趋势
Marshall A Diven1,2, Lhaden Tshering2, Xiaoyue Ma3
1New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, New York.
JAMA network open
|August 22, 2024
概括
从2010年到2020年,中等风险前列腺癌的积极监测增加了四倍,显示出越来越多的采用. 这一趋势在有利和不利的风险群体中都被观察到,这表明治疗策略在不断变化.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 中等风险前列腺癌的初始治疗缺乏明确的治疗建议.
- 积极监测是对新诊断患者的不断发展的管理策略.
研究的目的:
- 描述美国中等风险前列腺癌的初始管理的国家趋势.
- 分析在这个患者群体中使用主动监测的情况.
主要方法:
- 一项队列研究分析了来自国家癌症数据库 (2010-2020) 的数据.
- 用国家综合癌症网络指南对患者进行了分层.
- 研究了主动监控使用的时间趋势,并对有利风险和不利风险进行了子组分析.
主要成果:
- 积极监控的使用率从2010年的2.0%增加了四倍,到2020年的8.6%.
- 在有利的 (2.4%至13.5%) 和不利的 (1.2%至3.1%) 中间风险组中,增幅显著.
- 多变量分析确定了与积极监视使用相关的因素,包括年龄,格里森得分,T阶段,社会经济地位和治疗设施特征.
结论:
- 对于中等风险前列腺癌,越来越多地实施积极监测.
- 需要进一步研究将基因组学和人工智能结合起来,以优化治疗建议.
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