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The association of type and number of high-risk criteria with cancer-specific mortality in prostate cancer patients treated with radical prostatectomy

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Current Urology 2024年第2期18卷 128-132页

作者： Francesco Chierigo Rocco Simone Flammia GabrieleSorce Benedikt Hoeh Lukas Hohenhorst Andrea Panunzio Zhe Tian Fred Saad Marcus Graefen Michele Gallucci Alberto Briganti Francesco Montorsi Felix K.H.Chun Shahrokh F.Shariat Alessandro Antonelli Giovanni Guano Guglielmo Mantica Marco Borghesi Nazareno Suardi Carlo Terrone Pierre I.Karakiewicz Department of Surgical and Diagnostic Integrated Sciences University of GenovaGenovaItaly IRCCS Ospedale Policlinico San Martino GenovaItaly cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity ofMontréal Health CenterMontréalQuébecCanada Department of Urology IRCCS Policlinico San MartinoGenovaItaly Department of Maternal-Child and Urological Sciences Sapienza Rome UniversityPoliclinico Umberto I HospitalRomeItaly Department of Urology University Hospital FrankfurtFrankfurt am MainGermany Martini-Klinik Prostate cancer Center University Hospital Hamburg-EppendorfHamburgGermany Department of Urology University of VeronaAzienda Ospedaliera Universitaria Integrata di VeronaVeronaItaly Division of Experimental Oncology/Unit of Urology URIUrological Research InstituteIRCCS San Raffaele Scientific InstituteMilanItaly Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Department of Urology Second Faculty of MedicineCharles UniversityPragueCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Division of Urology Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan

Objectives:This study aimed to test the association between of type and number of D'Amico high-risk criteria(DHRCs)with cancer-specific mortality(CSM)in high-risk prostate cancer patients treated with radical *** and methods:In the Surveillance,Epidemiology,and End Results database(2004–2016),we identified 31,281 radical prostatectomy patients with at least 1 DHRC,namely,prostate-specific antigen(PSA)>20 ng/mL(hrPSA),biopsy Gleason Grade Group(hrGGG)score of 4 and 5,or clinical tumor stage≥T3(hrcT).Multivariable Cox regression models and competing risks regression models(adjusting for other cause mortality)tested the association between DHRCs and 5-year ***:Of 31,281 patients,14,394(67%)exclusively harbored hrGGG,3189(15%)harbored hrPSA,and 1781(8.2%)harbored *** 2132 patients(6.8%)harbored a combination of the 2 DHRCs,and 138(0.6%)had all 3 ***-year CSMrates ranged from 0.9%to 3.0%when any individual DHRC was present(hrcT,hrPSA,and hrGGG,in that order),1.6%to 5.9%when 2 DHRCs were present(hrPSA-hrcT,hrcT-hrGGG,and hrPSA-hrGGG,in that order),and 8.1%when all 3 DHRCs were *** regression models and competing risks regression confirmed the independent predictor status of DHRCs for 5-year CSM that was observed in univariable analyses,with hazard ratios from 1.00 to 2.83 for 1 DHRC,2.35 to 5.88 for combinations of 2 DHRCs,and 7.13 for all 3 ***:Within individual DHRCs,hrcT and hrPSA exhibited weaker effects than hrGGG ***,a dose-response effect was identified according to the number of ***,the type and number of DHRCs allow further risk stratification within the high-risk subgroup.

关键词： High risk prostate cancer Radical prostatectomy cancer-specific mortality Staging SEER

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The comparison of survival between active surveillance or watchful waiting and focal therapy for low-risk prostate cancer:a real-world study from the SEER database

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Asian Journal of Andrology 2022年第3期24卷 305-310页

作者： Qi-Ming Yuan Tian-Hai Lin Kun Jin Shi Qiu Xiang-Hong Zhou Di Jin Jia-Kun Li Lu Yang Qiang Wei Department of Urology Institute of UrologyWest China Hospital of Sichuan UniversityChengdu 610041China

To reduce treatment-related side effects in low-risk prostate cancer(PCa),both focal therapy and deferred treatments,including active surveillance(AS)and watchful waiting(WW),are worth considering over radical prostatectomy(RP).Therefore,this study aimed to compare long-term survival outcomes between focal therapy and AS/*** were obtained and analyzed from the Surveillance,Epidemiology,and End Results(SEER)*** with low-risk PCa who received focal therapy or AS/WW from 2010 to 2016 were *** therapy included cryotherapy and laser *** Cox proportional hazards models were used to compare overall mortality(OM)and cancer-specific mortality(CSM)between AS/WW and focal therapy,and propensity score matching(PSM)was performed to reduce the influence of bias and unmeasured confounders.A total of 19292 patients with low-risk PCa were included in this *** multivariate Cox proportional hazards model analysis,the risk of OM was higher in patients receiving focal therapy than those receiving AS/WW(hazard ratio[HR]=1.35,95%confidence interval[CI]:1.02–1.79,P=0.037),whereas no significant difference was found in CSM(HR=0.98,95%CI:0.23–4.11,P=0.977).After PSM,the OM and CSM of focal therapy and AS/WW showed no significant differences(HR=1.26,95%CI:0.92–1.74,P=0.149;and HR=1.26,95%CI:0.24–6.51,P=0.782,respectively).For patients with low-risk PCa,focal therapy was no match for AS/WW in decreasing OM,suggesting that AS/WW could bring more overall survival benefits.

关键词： active surveillance cancer-specific mortality focal therapy low-risk prostate cancer overall mortality watchful waiting

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