METHODS: We relied on an institutional tertiary-care database to identify mmPCa patients. Kaplan Meier and Cox Regression models tested for onset of metastases and OS, stratified according to GS, pathological stage and time to mmPCa.
RESULTS: Of 341 mmPCa patients, 8% harbored GS6 versus 41% versus 51% GS7 and GS8-10. Median time to onset of metastatic disease was 79 versus 54 versus 41 months for GS6 versus GS7 versus GS8-10 (P = .01). Moreover, median time to onset of metastases was 64 versus 44 months for pT1-2 versus pT3-4 mmPCa patients undergoing radical prostatectomy (P = .027). In multivariable Cox regression models, higher GS and pT-stage was associated with earlier onset of metastases. Additionally, significant OS differences could be observed for time interval of < 24 versus 24-60 versus 60-120 versus ≥ 120 months between primary PCa diagnosis and onset of mmPCa. Specifically, median OS was 56 versus 69 versus 97 months versus not reached (P < .01) for these categories. In multivariable Cox regression, shorter time to metastatic onset was associated with shorter OS.
CONCLUSIONS: Timing of mmPCa is strongly influenced by grading and pT-stage in real-life setting. OS benefits can be observed with longer time interval between primary PCa diagnosis and onset of mmPCa.
方法:我们依靠机构三级护理数据库来识别mmPCa患者。KaplanMeier和Cox回归模型测试了转移和OS的发作,根据GS分层,MPCa的病理分期和时间。
结果:在341名mmPCa患者中,8%的人持有GS6,而41%的人持有GS7和GS8-10的比例为51%。GS6与GS7与GS8-10的转移性疾病发病的中位时间分别为79个月和54个月和41个月(P=0.01)。此外,接受根治性前列腺切除术的pT1-2和pT3-4mmPCa患者发生转移的中位时间分别为64个月和44个月(P=.027).在多变量Cox回归模型中,较高的GS和pT分期与较早发生转移相关.此外,在原发性PCa诊断和mmPCa发病之间的时间间隔<24个月和24-60个月和60-120个月和≥120个月时,可以观察到显著的OS差异.具体来说,这些类别的中位OS分别为56个月和69个月和97个月,与未达到相比(P<.01).在多变量Cox回归中,转移发作时间较短与OS较短相关.
结论:在现实生活中,mmPCa的时间受到分级和pT分期的强烈影响。在原发性PCa诊断和mmPCa发作之间的时间间隔较长时,可以观察到OS益处。