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首页> 外文期刊>International journal of urology: official journal of the Japanese Urological Association >Radical prostatectomy and adjuvant endocrine therapy for prostate cancer with or without preoperative androgen deprivation: Five-year results.
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Radical prostatectomy and adjuvant endocrine therapy for prostate cancer with or without preoperative androgen deprivation: Five-year results.

机译：前列腺癌根治性前列腺切除术和辅助内分泌治疗，伴或不伴术前雄激素剥夺：五年结果。

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BACKGROUND: The effects of preoperative androgen deprivation on the outcomes of prostate cancer patients who received radical prostatectomy and subsequent adjuvant endocrine therapy have not yet been fully evaluated. METHODS: Patients with stage A(2), B or C prostate cancers were randomized to one of two groups: group I (n = 90), who received androgen deprivation (leuprolide and chlormadinone acetate) for 3 months followed by radical prostatectomy and subsequent adjuvant endocrine therapy (leuprolide alone), and group II (n = 86), who underwent the surgery followed by 3-month androgen deprivation (leuprolide and chlormadinone acetate) and subsequent adjuvant endocrine therapy (leuprolide alone). The effects of preoperative androgen deprivation on survival, clinical relapse (serum prostate specific antigen, PSA, above the normal level, local recurrence, or distant metastases), and PSA relapse (PSA above the detectable level) were evaluated at 5 years or later after treatment. RESULTS: There were no significant differences in overall, cause-specific, clinical relapse-free, or PSA relapse-free survival rates between the two groups. In a subanalysis, no prostate cancer deaths or clinical relapses were noted in 29 patients with organ-confined disease (OCD: negativity of capsular invasion, seminal vesicle invasion, surgical margins or nodal involvement). The odds ratio for OCD depending on group assignment was 2.44 (95% confidence interval, CI 1.04-5.72), for group I, demonstrating a higher probability of having OCD. This ratio was increased to 4.00 (95% CI 1.06-15.16) if the analysis was conducted in a subpopulation with prostate specific antigen levels less than 35.6 ng/mL and with clinical stage B or C cancers. CONCLUSION: Preoperative androgen deprivation has no demonstrable benefit in 5-year outcomes for patients undergoing radical prostatectomy and adjuvant endocrine therapy. However, it did increase the probability of OCD, which was associated with no clinical relapse during the follow-up. A longer observation is needed to clarify the exact extent of the benefits in terms of survival.
机译：背景：术前雄激素剥夺对接受根治性前列腺切除术和随后辅助内分泌治疗的前列腺癌患者预后的影响尚未得到充分评估。方法：将患有A（2），B或C期前列腺癌的患者随机分为两组：I组（n = 90），他们接受了3个月的雄激素剥夺（亮丙瑞林和醋酸氯麦定），然后进行了前列腺癌根治术，随后进行了治疗。辅助内分泌治疗（单独使用亮丙瑞林）和第二组（n = 86），他们接受了手术，随后进行了3个月的雄激素剥夺（亮丙瑞林和醋酸氯麦定）和随后的辅助内分泌治疗（单独使用亮丙瑞林）。在5年或更晚之后评估术前雄激素剥夺对生存，临床复发（血清前列腺特异性抗原，PSA，高于正常水平，局部复发或远处转移）和PSA复发（PSA高于可检测水平）的影响。治疗。结果：两组的总体，因因，临床无复发或PSA无复发生存率无显着差异。在一项亚分析中，未发现29例器官受限疾病患者的前列腺癌死亡或临床复发（OCD：荚膜浸润，精囊浸润，手术切缘或淋巴结转移阴性）。对于I组，取决于组的分配，OCD的优势比为2.44（95％置信区间，CI 1.04-5.72），表明患OCD的可能性更高。如果在前列腺特异性抗原水平低于35.6 ng / mL的亚人群中进行临床B或C期癌症，则该比率增加至4.00（95％CI 1.06-15.16）。结论：对于接受根治性前列腺切除术和辅助内分泌治疗的患者，术前雄激素剥夺对5年结局无明显益处。但是，它确实增加了强迫症的可能性，这与随访期间无临床复发相关。需要进行更长的观察，以明确这些益处在生存方面的确切范围。

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