对有利的中期风险前列腺癌和死亡风险的监测与治疗
Mutlay Sayan1, Yetkin Tuac2, Zhiyu Qian3,4
1Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts, USA.
The Prostate
|March 9, 2026
概括
年轻的前列腺癌 (PC) 中期风险有利的年轻男性有类似的低死亡风险,无论是通过积极监测 (AS) 或立即治疗进行管理. 在这项研究中,种族并没有显著改变这些结果.
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
- 公共卫生 公共卫生
背景情况:
- 积极监测 (AS) 是低风险前列腺癌 (PC) 的标准.
- 较年轻的患者 (<60岁) 的死亡风险在AS上具有有利中等风险 (FIR) PC并未得到充分确立.
- 这项研究调查了AS和在年轻的FIR PC患者中立即治疗之间的死亡率差异,按种族分层.
研究的目的:
- 评估FIR PC的年轻患者 (<60岁) 的全因,PC特异性和非PC特异性死亡率.
- 为了比较AS/警等待 (WW) 和即时的最终治疗 (急性前列腺切除术/放射治疗) 之间的结果.
- 探索种族 (白人与代表性不足的少数民族 (URM)) 对这些死亡风险的影响.
主要方法:
- 使用2010-2020年SEER数据进行的回顾性队列研究.
- 包括的患者年龄小于60岁,有FIR PC.
- 使用多变量Cox和Fine-Gray竞争风险回归,统计显著性设置为p<0.025.
主要成果:
- 在3832名患者中,127人死亡 (3.31%),其中18人为PC特定的死亡 (14.17%).
- 与AS/WW相比,即时治疗 (RP/RT) 在白色或URM患者中没有显著降低全因或非PC特定死亡率.
- 在URM患者中,RP/RT显著降低了PC特异性死亡率 (AHR 0.03),但不是白人患者 (AHR 0.21).
结论:
- 早期死亡风险较低,对于FIR PC的年轻患者 (<60岁) 来说是相似的,无论管理方式 (AS/WW vs. RP/RT) 或种族.
- 虽然立即治疗在白人患者中显示出降低PC特异性死亡率的趋势,但仅在URM患者中显著.
- 研究结果表明,AS对于精心挑选的年轻FIR PC患者来说是一个可行的选择.
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