积极监测中的协议异质性是否会影响临床结果? 来自多中心前列腺癌队列的见解
Young Hwii Ko1, Jae Hyun Ryu2, Yun Beom Kim2
1Department of Urology, Ewha Urology Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Investigative and clinical urology
|March 3, 2026
概括
针对低风险前列腺癌的积极监测 (AS) 协议因机构而异,影响监测持续时间和治疗时间,但不影响病理结果. 需要基于证据的标准化.
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.
- 临床研究 临床研究
背景情况:
- 积极监测 (AS) 是低风险前列腺癌的推管理策略.
- 在AS资格标准,活检政策和监测时间表中存在显著的机构变化.
研究的目的:
- 评估异质主动监测协议对监测持续时间,治疗过渡和外科病理结果的影响.
- 为了比较三个具有不同的AS协议的机构的结果.
主要方法:
- 在2014年至2016年期间,在三个医院进行了232名男性的回顾性审查,这些男性在不同的协议下开始AS.
- 卡普兰-梅尔和考克斯对AS延续和治疗过渡的回归分析.
- 在接受激进前列腺切除术 (RP) 的男性中,最终的格里森等级组 (GGG) 和病理阶段的比较.
主要成果:
- 中位数AS持续时间为38.5个月,在5年AS保留时间中存在显著差异 (A医院:53.2%,B医院:79.8%,C医院:59.1%).
- 治疗过渡率有显著差异 (p=0.003),B医院的过渡风险最低,C医院的RP风险较高.
- 在接受RP的男性中,在最终的GGG或病理阶段没有观察到显著的差异.
结论:
- 在AS协议中的机构异质性显著影响了监测持续时间和治疗时间.
- 通过适当的确认活检和风险调整的监测,可以接受协议的灵活性.
- 需要对前列腺癌的积极监测协议进行基于证据的标准化.
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