在观察性研究中对患有晚期前列腺癌的男性进行疾病进展的不同定义的后果
Eugenio Ventimiglia1, Marcus Westerberg2, Paolo Zaurito3
1Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. eugenio.ventimiglia@uu.se.
Scandinavian journal of urology
|February 4, 2026
概括
不同的前列腺特异性抗原进展的定义,在前列腺癌的病人上色素缺乏治疗显著影响进展估计,但不是治疗开始或死亡率. 临床决策可能依赖于超出正式进展标准的因素.
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
- 临床研究 临床研究
背景情况:
- 对于接受雄激素剥夺疗法 (ADT) 的前列腺癌患者,前列腺特异性抗原 (PSA) 进展定义主要来自随机试验.
- 这些定义对现实世界临床实践的适用性是不确定的.
研究的目的:
- 评估基于PSA的不同进展定义对进行ADT的前列腺癌男性的进展估计,治疗开始和结果的影响.
- 为了比较各种修改后的基于指南的定义,包括欧洲泌尿病学协会 (EAU) 和PCBase标准.
主要方法:
- 利用来自瑞典前列腺癌数据库 (PCBase Xtend) 的3718名开始ADT的男性数据 (2009-2022年).
- 分析了纵向PSA和治疗数据,使用四个修改后的标准来定义PSA进展.
- 评估了PSA进展的累积发病率,割抵抗性前列腺癌后进展的治疗,以及前列腺癌特异性死亡率,考虑了竞争风险.
主要成果:
- 经历PSA进展的男性数量根据定义有很大的差异,从28% (EAU) 到64% (PCBase) 在10年内.
- 较不严格的标准导致了更早的进展,平均时间差异为3个月.
- 尽管进展发生率有差异,但进展后5年内开始治疗 (45-52%) 和前列腺癌特异性死亡率 (26-27%) 在定义上仍然相似.
结论:
- 在临床实践中,PSA进展定义大大改变了估计的疾病发病率,但对治疗决策和长期死亡率的影响有限.
- 临床管理决策似乎受到超出正式PSA进展标准的因素的影响.
- 基于PSA的定义在通过敏感性分析支持的观察性研究中可能是有价值的.
相关概念视频
Observational Studies
11.1K
Observational studies are a type of analytical study where researchers observe events without any interventions. In other words, the researcher does not influence the response variable or the experiment's outcome.
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
11.1K
mTOR Signaling and Cancer Progression
4.8K
The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...
The mTOR pathway or the...
4.8K
Timing and Consequences on Behavior
398
In operant conditioning, the timing of reinforcement is crucial. For animals like rats and cats, immediate reinforcement (within a few seconds) is much more effective than delayed reinforcement. For example, a food reward for a rat needs to follow within 30 seconds of pressing a bar to be effective.
Humans, however, can respond to delayed reinforcers. We often make decisions between immediate small rewards and delayed larger rewards. This ability to delay gratification is a significant...
Humans, however, can respond to delayed reinforcers. We often make decisions between immediate small rewards and delayed larger rewards. This ability to delay gratification is a significant...
398
Definite Integral
75
Consider a real-valued function defined on a closed interval. One of the fundamental objectives in calculus is to determine the area under the graph of such a function. When an exact computation is not readily available, this area can be estimated by dividing the interval into a finite number of equal subintervals. Each subinterval corresponds to a rectangle whose width is the length of the subinterval and whose height is determined by the value of the function at a selected point within that...
75
Definition of z-Transform
1.6K
The z-transform is a powerful mathematical tool used in the analysis of discrete-time signals and systems. It is an essential analytical tool, analogous to the Laplace transform used in continuous-time systems. It plays a crucial role in the analysis of signals and systems, complementing the discrete-time Fourier transform. Both the z-transform and the Laplace transform convert differential or difference equations into algebraic equations, simplifying the process of solving complex problems.
1.6K
Naturalistic Observations
17.4K
If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances...
17.4K


