激进前列腺切除术后pN1前列腺癌的预后分层:来自多机构队列的竞争性风险分析
Alexander Giesen1,2, Daimantas Milonas1,3, Annouschka Laenen4
1Department of Urology, University Hospitals Leuven, Leuven, Belgium.
European urology open science
|August 18, 2025
概括
阳性淋巴结 (pN1) 的前列腺癌患者有不同的结果. 使用pt阶段,手术边缘和淋巴结数量的新模型对风险进行分层,帮助个性化治疗决策.
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
- 病理学 病理学 病理学
背景情况:
- 淋巴结阳性 (pN1) 状态的前列腺癌 (PCa) 是高度可变的.
- 准确的预后分组对于PN1患者至关重要.
- 需要进行癌症相关死亡率 (CRM) 风险分层.
研究的目的:
- 在pN1患者的不同预后组中评估CRM.
- 根据病理性PCa特征和淋巴结数量开发一个预后模型.
- 为了预测CRM考虑竞争风险.
主要方法:
- 对894名pN1患者进行了回顾性多中心队列研究.
- 识别和汇集CRM的独立预测指标.
- 使用pt阶段,手术边缘 (SM) 状态和淋巴结阳性 (LN+) 数量构建预后模型.
主要成果:
- 开发了一个三组预后模型 (有利,中等,差).
- 关键预测因素包括pT阶段,SM状态和LN+数量.
- 10年累计的CRM利率为12%,32%和58%,分别为各组 (p < 0.005).
结论:
- PN1患者群体表现出显著的异质性.
- 主要癌症特征仍然是PN1疾病中CRM的关键驱动因素.
- 该模型有助于为pN1患者进行手术后的个性化临床决策.
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