Radiotherapy plus androgen deprivation therapy for prostate-specific antigen persistence in lymph node-positive prostate cancer

被引：11

作者：

Shiota, Masaki ^{[1
]}

Takamatsu, Dai ^{[1
]}

Kimura, Takahiro ^{[2
]}

Tashiro, Kojiro ^{[2
]}

Matsui, Yoshiyuki ^{[3
]}

Tomida, Ryotaro ^{[4
]}

Saito, Ryoichi ^{[5
]}

Tsutsumi, Masakazu ^{[6
]}

Yokomizo, Akira ^{[7
]}

Yamamoto, Yoshiyuki ^{[8
]}

Edamura, Kohei ^{[9
]}

Miyake, Makito ^{[10
]}

Morizane, Shuichi ^{[11
]}

Yoshino, Takayuki ^{[12
]}

Matsukawa, Akihiro ^{[13
]}

Narita, Shintaro ^{[14
]}

Matsumoto, Ryuji ^{[15
]}

Kasahara, Takashi ^{[16
]}

Hashimoto, Kohei ^{[17
]}

Matsumoto, Hiroaki ^{[18
]}

Kato, Masashi ^{[19
]}

Akamatsu, Shusuke ^{[20
]}

Joraku, Akira ^{[21
]}

Kato, Manabu ^{[22
]}

Yamaguchi, Takahiro ^{[23
]}

Saito, Toshihiro ^{[24
]}

Kaneko, Tomoyuki ^{[25
]}

Takahashi, Atsushi ^{[26
]}

Kato, Takuma ^{[27
]}

Sakamoto, Shinichi ^{[28
]}

Enokida, Hideki ^{[29
]}

Kanno, Hidenori ^{[30
]}

Terada, Naoki ^{[31
]}

Suekane, Shigetaka ^{[32
]}

Nishiyama, Naotaka ^{[33
]}

Eto, Masatoshi ^{[1
]}

Kitamura, Hiroshi ^{[33
]}

机构：

[1] Kyushu Univ, Dept Urol, Fukuoka, Japan

[2] Jikei Univ, Dept Urol, Sch Med, Tokyo, Japan

[3] Natl Canc Ctr, Dept Urol, Tokyo, Japan

[4] Shikoku Canc Ctr, Dept Urol, Matsuyama, Ehime, Japan

[5] Kansai Med Univ, Dept Urol & Androl, Osaka, Japan

[6] Hitachi Gen Hosp, Dept Urol, Hitachi, Ibaraki, Japan

[7] Harasanshin Hosp, Dept Urol, Fukuoka, Japan

[8] Osaka Int Canc Inst, Dept Urol, Osaka, Japan

[9] Okayama Univ, Dept Urol, Okayama, Japan

[10] Nara Med Univ, Dept Urol, Kashihara, Nara, Japan

[11] Tottori Univ, Fac Med, Dept Surg, Div Urol, Yonago, Tottori, Japan

[12] Univ Tsukuba, Dept Urol, Tsukuba, Ibaraki, Japan

[13] Jikei Univ, Kashiwa Hosp, Dept Urol, Chiba, Japan

[14] Akita Univ, Dept Urol, Akita, Japan

[15] Hokkaido Univ, Dept Renal & Genitourinary Surg, Sapporo, Hokkaido, Japan

[16] Niigata Univ, Dept Regenerat & Transplant Med, Div Urol, Niigata, Japan

[17] Sapporo Med Univ, Dept Urol, Sapporo, Hokkaido, Japan

[18] Yamaguchi Univ, Dept Urol, Ube, Yamaguchi, Japan

[19] Nagoya Univ, Dept Urol, Nagoya, Aichi, Japan

[20] Kyoto Univ, Dept Urol, Kyoto, Japan

[21] Ibaraki Cent Hosp, Ibaraki Canc Ctr, Dept Urol, Kasama, Ibaraki, Japan

[22] Mie Univ, Dept Nephrourol Surg & Androl, Tsu, Mie, Japan

[23] Kumamoto Univ, Dept Urol, Kumamoto, Japan

[24] Niigata Canc Ctr Hosp, Dept Urol, Niigata, Japan

[25] Teikyo Univ, Dept Urol, Sch Med, Tokyo, Japan

[26] Hakodate Goryoukaku Hosp, Dept Urol, Hakodate, Hokkaido, Japan

[27] Kagawa Univ, Dept Urol, Takamatsu, Kagawa, Japan

[28] Chiba Univ, Dept Urol, Chiba, Japan

[29] Kagoshima Univ, Dept Urol, Kagoshima, Japan

[30] Yamagata Univ, Dept Urol, Yamagata, Japan

[31] Miyazaki Univ, Dept Urol, Miyazaki, Japan

[32] Kurume Univ, Dept Urol, Sch Med, Kurume, Fukuoka, Japan

[33] Univ Toyama, Dept Urol, Toyama, Japan

来源：

CANCER SCIENCE | 2022年 / 113卷 / 07期

关键词：

androgen deprivation therapy; lymph node involvement; PSA persistence; radical prostatectomy; radiotherapy; RADICAL PROSTATECTOMY; ADJUVANT RADIOTHERAPY; SURVIVAL; DISSECTION; OUTCOMES; IMPACT;

D O I：

10.1111/cas.15383

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The treatment for lymph node involvement (LNI) after radical prostatectomy (RP) has not been established. This study aimed to reveal the outcomes of various management strategies among patients with LNI after RP. Retrospectively, 561 patients with LNI after pelvic lymph node dissection (PLND) with RP treated between 2006 and 2019 at 33 institutions participating in the Japanese Urological Oncology Group were investigated. Metastasis-free survival (MFS) was the primary outcome. Patients were stratified by prostate-specific antigen (PSA) persistence after RP. Cox regression models were used to analyze the relationships between clinicopathological characteristics and survival. Survival analyses were conducted using the Kaplan-Meier method and log-rank test with or without propensity score matching. Prognoses, including MFS and overall survival, were prominently inferior among patients with persistent PSA compared with those without persistent PSA. In multivariate analysis, androgen deprivation therapy (ADT) plus radiotherapy (RT) was associated with better MFS than ADT alone among patients with persistent PSA (hazard ratio = 0.37; 95% confidence interval = 0.15-0.93; p = 0.034). Similarly, MFS and overall survival were significantly better for ADT plus RT than for ADT alone among patients with persistent PSA after propensity score matching. This study indicated that PSA persistence in LNI prostate cancer increased the risk of poor prognoses, and intensive treatment featuring the addition of RT to ADT might improve survival.

引用

页码：2386 / 2396

页数：11

共 23 条

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