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淋巴结阳性前列腺癌的治疗模式和结果:国家癌症数据库研究

Andrea Piccolini¹, Stephan M Korn², Zhiyu Qian³

¹Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Clinical genitourinary cancer

|August 29, 2025

概括

淋巴结参与的前列腺癌 (pN1) 的治疗方法各不相同. 与辅助放射治疗相结合,可显著改善整体存活率,但仍未得到充分利用.

科学领域:

尿道病学
癌症学
癌症研究

背景情况:

在急性前列腺切除术后,淋巴结参与 (pN1) 表明前列腺癌的预后较差.
对于pN1前列腺癌的最佳术后治疗仍然是争论的主题.
本研究评估了pN1前列腺癌患者的治疗模式和瘤结果.

研究的目的:

分析pN1前列腺癌患者的治疗模式和整体存活率.
在该患者队列中确定治疗选择的预测因素.
评估不同治疗策略对瘤结果的影响.

主要方法:

从国家癌症数据库 (NCDB) 对pN1患者 (2010-2020) 的数据分析.
排除远程转移或延迟辅助治疗的患者.
使用治疗权重的反向概率 (IPTW) 进行生存分析.

主要成果:

分析了超过13,000名pN1患者,51. 2%接受观察,17. 8%仅接受ADT,26. 9%的ADT加上aRT和4. 1%的aRT.
治疗强化与更高的ISUP等级,pT3- 4疾病和节点负担有关.
与辅助放射治疗相结合的安德روج因剥夺疗法显著改善了生存状况 (HR: 0. 78, P < . 001).

结论:

在pN1前列腺癌的术后治疗中存在显著的变异性.
辅助放射治疗,通常与ADT结合,与生存率的改善有关,但只有不到三分之一的符合条件的患者接受.
建议采用个性化,多学科的方法来管理pN1疾病.

关键词:

辅助放射治疗抗素剥夺疗法淋巴结的侵袭癌症结局前列腺癌

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