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首页> 外文期刊>Urology practice. >The Impact of Comorbidity and Age on Timing of Androgen Deprivation Therapy in Men with Biochemical Recurrence after Radical Prostatectomy
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The Impact of Comorbidity and Age on Timing of Androgen Deprivation Therapy in Men with Biochemical Recurrence after Radical Prostatectomy

机译：合并症和年龄对自由基前列腺切除术后生物化学复发的男性雄激素剥夺治疗时机的影响

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Introduction: Older men with major comorbidities have higher risks of morbidity and mortality from androgen deprivation therapy, and the benefits of immediate androgen deprivation therapy after biochemical recurrence in these men are unclear. We assessed variation in timing of androgen deprivation therapy by age and comorbidity in a cohort of men with biochemical recurrence after radical prostatectomy.Methods: We analyzed 2,097 men with biochemical recurrence after radical prostatectomy from 2000 to 2017 in the VA SEARCH database. We ascertained age and Deyo-Charlson comorbidity index scores at biochemical recurrence. Kaplan-Meier analysis and multivariable logistic regression were used to determine association of age and Deyo-Charlson comorbidity index with prostate specific antigen at the initiation of androgen deprivation therapy.Results: In Kaplan-Meier analysis with prostate specific antigen at androgen deprivation therapy as the outcome, median prostate specific antigen at androgen deprivation therapy initiation was 6.2 ng/ ml (95% CI 5.1—7.1) across all patients but differed among those who received adjuvant/salvage radiation (3.6 ng/ml, 95% CI 2.8-4.3) and those who did not (12.1 ng/ml, 95% CI 9.6-15.2, p <0.001). In multivariable Cox regression, advanced age (p=0.03) but not worse comorbidity (p=0.25) was associated higher prostate specific antigen at initiation of androgen deprivation therapy. Across all patients, prostate specific antigen at androgen deprivation therapy was lower among those <60 years old (3.7 ng/ml, 95% CI 2.6-5.8) compared to those 60—64 (5.0 ng/ml, 95% CI 3.9-6.6), 65-69 (6.6 ng/ml, 95% CI 4.9-8.8), 70-74 (8.8 ng/ml, 95% CI 6.1-12.3) and >75 years old (14.1 ng/ml, 95% CI 5.5—37.8).
机译：导言：患有严重共病的老年男性在雄激素剥夺治疗中有更高的发病率和死亡率风险，这些男性生化复发后立即进行雄激素剥夺治疗的益处尚不清楚。我们评估了前列腺癌根治术后生化复发男性队列中年龄和共病对雄激素剥夺治疗时间的影响。方法：我们在VA搜索数据库中分析了2000年至2017年间2097例前列腺癌根治术后生化复发的男性患者。我们确定了生化复发时的年龄和Deyo-Charlson共病指数得分。Kaplan-Meier分析和多变量logistic回归用于确定在雄激素剥夺治疗开始时年龄和Deyo-Charlson共病指数与前列腺特异性抗原的相关性。结果：在以雄激素剥夺治疗时的前列腺特异性抗原为结果的Kaplan-Meier分析中，所有患者在雄激素剥夺治疗开始时的前列腺特异性抗原中位数为6.2ng/ml（95%可信区间5.1-7.1），但在接受辅助/挽救放疗的患者（3.6ng/ml，95%可信区间2.8-4.3）和未接受辅助/挽救放疗的患者（12.1ng/ml，95%可信区间9.6-15.2，p<0.001）之间存在差异。在多变量Cox回归分析中，高龄（p=0.03）而非更糟的共病（p=0.25）与雄激素剥夺治疗开始时较高的前列腺特异性抗原相关。在所有患者中，与60-64岁（5.0 ng/ml，95%可信区间3.9-6.6）、65-69岁（6.6 ng/ml，95%可信区间4.9-8.8）、70-74岁（8.8 ng/ml，95%可信区间6.1-12.3）和75岁以上（14.1 ng/ml，95%可信区间5.5-37.8）患者相比，60岁以下患者在雄激素剥夺治疗时的前列腺特异性抗原较低（3.7 ng/ml，95%可信区间2.6-5.8）。

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