河北医科大学第四医院前列腺癌患者的基线特征与生存分析  

Baseline characteristics and survival analysis of patients with prostate cancer in the Fourth Hospital of Hebei Medical University

作　　者：樊博[1] 齐盼[1] 苏建志[1] 卫书飞 张轩 张爱莉[1] FAN Bo;QI Pan;SU Jianzhi;WEI Shufei;ZHANG Xuan;ZHANG Aili(Department of Urology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Graduate School of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]河北医科大学第四医院泌尿外科,河北石家庄050000 [2]河北医科大学研究生学院,河北石家庄050000

出　　处：《中国癌症杂志》2020年第8期620-625,共6页China Oncology

摘　　要：背景与目的:近年来,前列腺癌发病率逐年增高,但前列腺癌筛查工作仍不全面,国内前列腺癌数据库也相对匮乏。分析河北医科大学第四医院前列腺癌患者的基线特征、治疗以及生存情况等数据,为河北及周边地区前列腺癌的诊治提供参考。方法:回顾性分析2008年1月-2018年12月在河北医科大学第四医院泌尿外科就诊的857例前列腺癌患者信息,分析初次就诊时非转移性(M0)和转移性(M1)前列腺癌患者的基线特征、治疗方案和生存情况。对随访数据采用Kaplan-Meier法绘制生存曲线,并用log-rank检验比较两组之间生存率差异。结果:纳入基线统计的患者共计857例,中位年龄71岁,797例存在前列腺特异性抗原(prostate-specific antigen,PSA)记录,689例存在Gleason评分记录。412例M0患者和445例M1患者中,PSA≥100 ng/mL的患者分别占11.1%(44/397)和57.3%(229/400),Gleason评分≥8分的患者分别占46.9%(166/354)和63.9%(214/335)。纳入随访分析的患者共计606例,患者生存395例,死亡211例,其中182例死于肿瘤进展。M0和M1患者5年生存率分别为63.2%(76/120)和41.3%(102/247),M0和M1患者的中位生存期分别为85和47个月(P<0.01)。此外,在所有采用传统内分泌治疗[雄激素剥夺治疗(androgen deprivation therapy,ADT)或联合雄激素阻断治疗(combined androgen blockade,CAB)]的M1患者和高危转移性激素敏感性前列腺癌(metastatic hormonesensitive prostate cancer,mHSPC)患者中,中位PSA进展时间(time to PSA progression,TTPP)分别为18和17个月。内分泌治疗初诊M0患者的中位TTPP为25个月。12例影像学检测未发现远处转移的去势抵抗性前列腺癌(non-metastatic castrateresistant prostate cancer,NM-CRPC)患者,中位无转移生存期(metastasis-free survival,MFS)仅为16个月。结论:前列腺癌患者的年龄、PSA及Gleason评分偏高,多数患者在治疗时有转移,5年生存率偏低,因此应重视和加强前列腺癌的筛查工作。在接�Background and purpose:In recent years,the incidence of prostate cancer has increased year by year,the screening of prostate cancer is still not comprehensive,and the domestic prostate cancer database is also relatively scarce.The purpose of this study was to analyze baseline characteristics,treatment and survival of prostate cancer patients from the Fourth Hospital of Hebei Medical University,in order to provide reference for the diagnosis and treatment of prostate cancer in Hebei and its surrounding areas.Methods:The information of 857 patients with prostate cancer treated in the Department of Urology,the Fourth Hospital of Hebei Medical University from Jan.2008 to Dec.2018 were analyzed retrospectively.Patients with non-metastatic prostate cancer(M0)or distant metastatic prostate cancer(M1)were analyzed for baseline characteristics,treatment and survival at the time of first visit.Kaplan-Meier method was used to draw survival curves,and log-rank test was used to compare survival rates between the two groups.Results:A total of 857 patients were included in the baseline statistics.Among those,797 cases had prostate-specific antigen(PSA)record,and 689 cases had Gleason score record.The median age of all patients was 71 years.Among 412 M0 patients and 445 M1 patients,11.1%(44/397)and 57.3%(229/400)patients had a PSA of≥100 ng/mL respectively,as well as 46.9%(166/354)and 63.9%(214/335)patients had a Gleason score of≥8 respectively.A total of 606 patients were included in the follow-up analysis,395 patients survived,and 211 patients died.A total of 182 patients died of tumor progression.The 5-year survival rates of M0 and M1 patients were 63.2%(76/120)and 41.3%(102/247)respectively.The median overall survival time of M0 and M1 patients were 85 months and 47 months(P<0.01)respectively.Additionally,in all M1 patients and high-risk metastatic hormone-sensitive prostate cancer(mHSPC)patients using traditional endocrine therapy(androgen deprivation therapy,ADT or combined androgen blockade,CAB),the median time to PSA

关 键 词：前列腺癌 随访 生存 进展 

分 类 号：R735.2[医药卫生—肿瘤]