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

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 

机构地区：[1]Department of Surgical and Diagnostic Integrated Sciences,University of Genova,Genova,Italy [2]IRCCS Ospedale Policlinico San Martino,Genova,Italy [3]Cancer Prognostics and Health Outcomes Unit,Division of Urology,University ofMontréal Health Center,Montréal,Québec,Canada [4]Department of Urology,IRCCS Policlinico San Martino,Genova,Italy [5]Department of Maternal-Child and Urological Sciences,Sapienza Rome University,Policlinico Umberto I Hospital,Rome,Italy [6]Department of Urology,University Hospital Frankfurt,Frankfurt am Main,Germany [7]Martini-Klinik Prostate Cancer Center,University Hospital Hamburg-Eppendorf,Hamburg,Germany [8]Department of Urology,University of Verona,Azienda Ospedaliera Universitaria Integrata di Verona,Verona,Italy [9]Division of Experimental Oncology/Unit of Urology,URI,Urological Research Institute,IRCCS San Raffaele Scientific Institute,Milan,Italy [10]Department of Urology,Comprehensive Cancer Center,Medical University of Vienna,Vienna,Austria [11]Department of Urology,Weill Cornell Medical College,New York,NY,USA [12]Department of Urology,University of Texas Southwestern,Dallas,TX,USA [13]Department of Urology,Second Faculty of Medicine,Charles University,Prague,Czech Republic [14]Institute for Urology and Reproductive Health,I.M.Sechenov First Moscow State Medical University,Moscow,Russia [15]Division of Urology,Department of Special Surgery,Jordan University Hospital,The University of Jordan,Amman,Jordan

出　　处：《Current Urology》2024年第2期128-132,共5页当代泌尿学（英文）

摘　　要：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 prostatectomy.Materials 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 CSM.Results:Of 31,281 patients,14,394(67%)exclusively harbored hrGGG,3189(15%)harbored hrPSA,and 1781(8.2%)harbored hrcT.Only 2132 patients(6.8%)harbored a combination of the 2 DHRCs,and 138(0.6%)had all 3 DHRCs.Five-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 present.Cox 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 DHRCs.Conclusions:Within individual DHRCs,hrcT and hrPSA exhibited weaker effects than hrGGG did.Moreover,a dose-response effect was identified according to the number of DHRCs.Accordingly,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 

分 类 号：R737.25[医药卫生—肿瘤]