Abstract：
The International Staging Collaboration for Prostate Cancer (STAR-CAP) has been proposed as a risk model for prostate cancer with superior prognostic power compared to the current staging system. This study aimed to evaluate the performance of STAR-CAP in predicting the risk of subsequent therapy after initial treatment and the risk of developing metastases.
The study included 3425 men from an institutional observational registry with a median age of 64.9 years and a median follow-up time of 5.4 years. The primary endpoints were metastases and progression to additional therapy after initial therapy (radiation ± surgery). The risk of progression in the STAR-CAP group was estimated using a competing risk model (death).
The results showed that patients with STAR-CAP stages 1A-1C had a similar risk of requiring additional therapies and developing metastasis. Compared to stage IC, each stage from 2A to 3B incrementally increased the risk of subsequent therapy (hazard ratio (HR) 1.4-5.8, respectively) and metastases (HR 1.5-10.8, respectively). The 5-year probability of receiving subsequent therapy for a patient with stage IC was 8.6%, which increased from 11.4% to 37.4% for those with stages 2A to 3B. The 5-year probability of developing metastases for patients with stage IC was 1.5%, which increased from 2.2% to 8.2% for patients with stages 2A to 3B.
The probability of receiving subsequent therapy was higher for patients undergoing surgery, while radiation therapy patients were more likely to receive treatment with intensified multimodality therapies upfront.
The study included 3425 men from an institutional observational registry with a median age of 64.9 years and a median follow-up time of 5.4 years. The primary endpoints were metastases and progression to additional therapy after initial therapy (radiation ± surgery). The risk of progression in the STAR-CAP group was estimated using a competing risk model (death).
The results showed that patients with STAR-CAP stages 1A-1C had a similar risk of requiring additional therapies and developing metastasis. Compared to stage IC, each stage from 2A to 3B incrementally increased the risk of subsequent therapy (hazard ratio (HR) 1.4-5.8, respectively) and metastases (HR 1.5-10.8, respectively). The 5-year probability of receiving subsequent therapy for a patient with stage IC was 8.6%, which increased from 11.4% to 37.4% for those with stages 2A to 3B. The 5-year probability of developing metastases for patients with stage IC was 1.5%, which increased from 2.2% to 8.2% for patients with stages 2A to 3B.
The probability of receiving subsequent therapy was higher for patients undergoing surgery, while radiation therapy patients were more likely to receive treatment with intensified multimodality therapies upfront.
摘要：
背景：国际前列腺癌分期合作（STAR-CAP）已被提出作为前列腺癌的风险模型，与目前的分期系统相比具有更高的预后能力。这项研究旨在评估STAR-CAP在预测初始治疗后后续治疗风险和发展转移风险方面的表现。
方法：该研究包括来自机构观察登记的3425名男性，中位年龄为64.9岁，中位随访时间为5.4年。主要终点是转移和初始治疗后进展到额外治疗(放射±手术)。使用竞争风险模型（死亡）估计STAR-CAP组的进展风险。
结果：结果显示，STAR-CAP1A-1C期患者需要额外治疗和发生转移的风险相似。与阶段IC相比，从2A到3B的每个阶段都会逐渐增加后续治疗的风险(风险比(HR)分别为1.4~5.8)和转移的风险(HR分别为1.5~10.8).IC期患者接受后续治疗的5年概率为8.6%，对于2A至3B阶段的人，从11.4%增加到37.4%。IC期患者发生转移的5年概率为1.5%，对于2A至3B期的患者，这一比例从2.2%增加到8.2%。
结论：接受手术的患者接受后续治疗的可能性更高，而放射治疗患者更有可能接受前期强化多模式治疗。
方法：该研究包括来自机构观察登记的3425名男性，中位年龄为64.9岁，中位随访时间为5.4年。主要终点是转移和初始治疗后进展到额外治疗(放射±手术)。使用竞争风险模型（死亡）估计STAR-CAP组的进展风险。
结果：结果显示，STAR-CAP1A-1C期患者需要额外治疗和发生转移的风险相似。与阶段IC相比，从2A到3B的每个阶段都会逐渐增加后续治疗的风险(风险比(HR)分别为1.4~5.8)和转移的风险(HR分别为1.5~10.8).IC期患者接受后续治疗的5年概率为8.6%，对于2A至3B阶段的人，从11.4%增加到37.4%。IC期患者发生转移的5年概率为1.5%，对于2A至3B期的患者，这一比例从2.2%增加到8.2%。
结论：接受手术的患者接受后续治疗的可能性更高，而放射治疗患者更有可能接受前期强化多模式治疗。
