雄激素非依赖性晚期转移性前列腺癌生存预后分析  

The survival analysis of the advanced metastatic castration-resistant prostate cancer

作　　者：马春光[1] 叶定伟[1] 姚旭东[1] 张世林[1] 戴波[1] 张海梁[1] 朱耀[1] 沈益君[1] 朱一平[1] 施国海[1] 秦晓健[1] 林国文[1] 杨立峰[1] 杨柏帅[1] 肖文军[1] 

机构地区：[1]复旦大学附属肿瘤医院泌尿外科复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华外科杂志》2009年第22期1712-1714,共3页Chinese Journal of Surgery

摘　　要：目的分析雄激素非依赖性晚期转移性前列腺癌的预后相关因素。方法1996年12月至2008年3月250例晚期转移件前列腺癌患者在内分泌治疗期间进展为雄激素非依赖性前列腺癌，对其进行随访，末次随访时间为2008年3月31日，中位随访时间为24个月（3～135个月）。未次随访时131例生存，105例死亡，14例失访。利用统计学软件进行生存预后分析。结果中位生存时间为30个月。1年生存率79％，2年生存率59％，3年生存率41％。单因素分析及多因素分析显示：内分泌治疗过程中PSA最低值、达到PSA最低值时间、进展为雄激素非依赖性前列腺癌时PSA速率、内分泌治疗有效时间为独立预后因素。结论内分泌治疗过程中PSA最低值、达到PSA最低值时间、进展为雄激素非依赖怍前列腺痛时的PSA速率和内分泌治疗有效时间为雄激素非依赖性晚期转移件前列腺癌生存时间的独赢预后凶素。Objective To analyze predictive factors of advanced metastatic castration-resistant prostate cancer. Methods From December 1996 to March 2008, 250 cases of advanced metastatic prostate cancer progressed into the stage of hormonal independent prostate cancer. The last follow-up date was 31 March 2008 and the median follow-up time was 24 months. During the follow-up, 131 cases were alive, 105 cases were dead and 14 cases were lost to follow-up. Clinical and pathological information of the cases was analyzed to find the predictive factors that related to the prognosis. Results The median survival time of advanced metastatic castration-resistant prostate cancer was 30 months, and the one-year, two-year, threeyear survival rate was 79% , 59% , and 41%. The univariate analysis indicated that prostate specific antigen （PSA） at diagnosis, clinical stage, the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, the time of response duration during hormonal therapy, PSA velocity （PSAV） and PSA doubling time （PSADT） at the emergency of castration-resistant prostate cancer, age and PSA at the diagnosis of castration-resistant prostate canner were factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-reslstant prostate cancer, the time of response duration during hormonal therapy were independent factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer. Conclusion The PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer and the time of response duration during hormonal therapy are independent factors that predict the survival time of advanced metastatic castration-resistant prostate cancer.

关 键 词：前列腺肿瘤 雄激素类 预后 

分 类 号：R686[医药卫生—骨科学]