■尽管前列腺癌根治术时盆腔淋巴结清扫术(PLND)的临床益处仍不确定,主要指南根据风险状况推荐PLND。因此,本研究的目的是在接受按Gleason分级组(GG)进行RP分层的患者中,研究PLND与生存率之间的关系,目的是让患者和医师对PLND的潜在风险和获益做出更明智的治疗决策.
■来自SEER-17数据库,我们检查了2010年至2015年接受RP治疗的前列腺癌患者的总体生存率(OS)和前列腺癌特异性生存率(PCSS),并按GG分层.我们应用倾向得分匹配来平衡术前特征,包括种族,年龄,PSA,家庭收入,和住房状况(城市/农村)的患者谁曾接受和未接受PLND为每个GG。统计分析包括对数秩检验和Kaplan-Meier曲线。
■我们从80,287例接受RP的GG1-5患者中提取了一个匹配的队列。PSA中位数为6.0ng/mL,中位年龄为62岁.49,453例患者接受PLND(61.60%),而30,834(38.40%)没有。对于所有GleasonGG,接受PLND的患者和未接受PLND的患者之间的OS和PCSS没有差异(OS-GG1:P=0.20,GG2:P=0.34,GG3:P>0.05,GG4:P=0.55,GG5:P=0.47;PCSS-GG1:P=0.11,GG3:P=0.81,G22=0.G4:P=0.14。
■在这项观察性研究中,在cGS为3+3、3+4、4+3、4+4、4+5和5+4的患者中,RP时的PLND与OS或PCSS改善无关。这些发现表明,在最终的临床试验完成之前,选择RP的前列腺癌患者应就PLND的潜在风险和缺乏经证实的生存获益进行适当咨询.
UNASSIGNED: Although the clinical benefits of pelvic lymph node dissection (PLND) at the time of radical prostatectomy for prostate cancer remain uncertain, major guidelines recommend PLND based on risk profile. Thus, the objective of this study was to examine the association between PLND and survival among patients undergoing RP stratified by Gleason grade group (GG) with the aim of allowing patients and physicians to make more informed care decisions about the potential risks and benefits of PLND.
UNASSIGNED: From the SEER-17 database, we examined overall (OS) and prostate cancer-specific (PCSS) survival of prostate cancer patients who underwent RP from 2010 to 2015 stratified by GG. We applied propensity score matching to balance pre-operative characteristics including race, age, PSA, household income, and housing status (urban/rural) between patients who did and did not undergo PLND for each GG. Statistical analyses included log-rank test and Kaplan-Meier curves.
UNASSIGNED: We extracted a matched cohort from 80,287 patients with GG1-5 who underwent RP. The median PSA value was 6.0 ng/mL, and the median age was 62-years-old. 49,453 patients underwent PLND (61.60%), while 30,834 (38.40%) did not. There was no difference in OS and PCSS between patients who received PLND and those who did not for all Gleason GG (OS-GG1: P = 0.20, GG2: P = 0.34, GG3: P > 0.05, GG4: P = 0.55, GG5: P = 0.47; PCSS-GG1: P = 0.11, GG2: P = 0.96, GG3: P = 0.81, GG4: P = 0.22, GG5: P = 0.14).
UNASSIGNED: In this observational study, PLND at the time of RP was not associated with improved OS or PCSS among patients with cGS of 3 + 3, 3 + 4, 4 + 3, 4 + 4, 4 + 5, and 5 + 4. These findings suggest that until definitive clinical trials are completed, prostate cancer patients who have elected RP should be appropriately counseled on the potential risks and lack of proven survival benefit of PLND.