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  

作　　者：Qi-Ming Yuan Tian-Hai Lin Kun Jin Shi Qiu Xiang-Hong Zhou Di Jin Jia-Kun Li Lu Yang Qiang Wei 

机构地区：[1]Department of Urology,Institute of Urology,West China Hospital of Sichuan University,Chengdu 610041,China

出　　处：《Asian Journal of Andrology》2022年第3期305-310,共6页亚洲男性学杂志（英文版）

基　　金：supported by the National Key Research and Development Program of China(SQ2017YFSF090096);the National Natural Science Foundation of China(81770756);the Sichuan Science and Technology Program(2017HH0063)。

摘　　要：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/WW.Data were obtained and analyzed from the Surveillance,Epidemiology,and End Results(SEER)database.Patients with low-risk PCa who received focal therapy or AS/WW from 2010 to 2016 were included.Focal therapy included cryotherapy and laser ablation.Multivariate 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 study.In 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 

分 类 号：R737.25[医药卫生—肿瘤]