摘要
目的探讨前列腺癌伴骨转移患者的初始前列腺特异性抗原（PSA）水平与双侧睾丸切除术联合氟他胺治疗后癌症特异生存（CSS）的相关性。方法收集1998--2002年在复旦大学附属华山医院泌尿外科初次诊断并收治的100例前列腺癌伴骨转移患者的临床资料，年龄54～88岁，中位年龄为74岁，T3NxM1期81例，T4NxM1期19例。所有患者接受双侧睾丸切除联合氟他胺治疗，术后随访3～156个月，中位随访时间为60个月。比较不同PSA水平患者的病史、体格检查、血清PSA值、前列腺B超和骨扫描检查结果及生存情况。结果100例患者根据PSA水平分为3组：A组（PSA％20ng／mL）25例，B组（PSA≥20且％50ng／mL）11例，c组（PSA≥50ng／mL）64例。3组患者间前列腺体积的差异有统计学意义（P〈0．05）。Gleason评分方面，A组高级别肿瘤的构成比虽高于B、C两组，但差异无统计学意义（P〉0．05）。A、B、C组患者的1年生存率分别为73．9％、100．0％和95．2％，2年生存率分别为39．1％、77．8％和83．9％，5年生存率分别为21．7％、33．3％和58．1％，10年生存率分别为13．0％、33．3％和29．0％。3组生存曲线的差异有统计学意义（P〈0．05），A组的预后显著差于B、c组。结论在采用双侧睾丸切除术联合氟他胺治疗的前列腺癌伴骨转移患者中，初始PSA水平较低（〈20ng／mL）者预后可能不佳。
Objective To investigate the association of initial prostate specific antigen （PSA） level in newly-diagnosed prostate cancer patients with bone metastasis with the cancer-specific survival （CSS） after of bilateral orchiectomy plus flutamide. Methods We retrospectively reviewed the clinical data of 100 newly-diagnosed prostate cancer patients with bone metastasis, who were treated in our hospital from 1998 to 2002 and aged 54- 88 years old （a median of 74 years old）. Eighty-one patients were in stage T3NxM1 and 19 in stage T4NxM1. All the patients received bilateral orchiectomy combined with the oral administration of flutamide. The post-operation follow-up varied from 3-156 months （median 60 months）. The association of case history, physical examinations, serum PSA level, transrectal ultrasound and radioisotope scanning with cancer.specific survival was analyzed. Results The 100 cases were divided into 3 groups according to the serum PSA levels, including 25 in Group A with PSA 〈20 ng/mL, 11 in group B with PSA 20-50 ng/mL, and 64 in group C with PSA〉50 ng/mL. The volumes of the prostate glands were significantly different between the 3 groups （P〈0.05）, but the Gleason scores were not significantly different between the ：3 groups（ P = 0. 302）. The 1-year survival rates of the A, B, and C groups were 73.9%, 100% and 95.2% ;the 2-year survival rates were 39.1%, 77.8% and 83.9% ; the 5- year survival rates were 21.7%, 3：3.3% and 58. 1%, and the 10-year survival rates were 13.0%, 33.3% and 29.0%, respectively. The survival curves of the 3 groups were significantly different between the ：3 groups （P〈 0.05）, with the survival period in A group shorter than those in B and C groups. Conclusion Prostate cancer patients with bone metastasis and an low initial PSA level may indicate a poor prognosis of patients after treatment with bilateral orchiectomy plus flutamide.
出处
《上海医学》
CAS
CSCD
北大核心
2011年第7期528-531,共4页
Shanghai Medical Journal
关键词
晚期前列腺癌
前列腺特异性抗原
内分泌治疗
预后
Advanced prostate cancer
Prostatic specific antigen
Endocrine therapy
Prognosis
