前列腺根治性切除术治疗前列腺癌骨转移或淋巴结转移患者的生存预后分析

The outcome of radical prostatectomy for prostate cancer patients with bone or lymphatic metastasis

目的探讨前列腺根治性切除术对前列腺癌骨转移或淋巴结转移患者生存预后的影响。方法将美国SEER数据库2004年至2013年间收录的淋巴结转移或骨转移的647例前列腺癌患者纳人研究,其中单独骨转移非手术组129例,单独骨转移手术组129例,单独淋巴结转移非手术组131例以及单独淋巴结转移手术组131例,无转移非手术组127例。分析并比较前列腺癌根治术对骨转移或淋巴结转移患者的总体生存率(0S)和肿瘤特异病死率(CSM)的影响。结果骨转移手术组和淋巴结转移手术组的患者术后0S和CSM分别优于骨转移非手术组和淋巴结转移非手术组(P<0.01)。骨转移手术组与无转移非手术组患者术后0S和CSM比较,差异无统计学意义(P>0.05)。淋巴结转移手术组术后oS和CSM优于无转移非手术组(P<0.01)。结论即使是发生骨转移和淋巴结转移的患者,经过仔细选择和准备,实施前列腺根治性切除术均可以改善患者生存率。

Objective To investigate the survival outcomes of prostate cancer patients who had bone or lymphatic metastasis according to whether they received radical prostatectomy.Methods A to-tal of 647 prostate cancer patients in the Survillance,Epidemiology,and End Resuls(SEER)data-base between 2004 and 2013 were included in this study.Of these,129 cases had bone metastasis and received prostatectomy,129 cases had bone metastasis but no prostatectomy,131 cases had lymph node metastasis and received prostatectomy,131 cascs had lymphatic metastasis without prostatectomy and 127 had non-metastatic disease and received no prostatectomy.The overall survivals(OS)and cause-speeifie mortality(CSM)of the different groups were analyzed and compared.Results The groups with bone metastasis and lymphatic metastasis who received radical prostatectomy had better postoperative OS and CSM than those who did not(P<0.05).The postoperative 0S and CSM did not differ between patients with bone metastasis who did or did not reeive surgery.Those with lymphatie metastasis who received surgery had better postoperative 0S and CSM than those who did not.Those with lymphatie metastasis and prostatectomy had better OS and CSM than non-metastatic patients with no surgery.Conclusions Even in patients with bone metastasis or lymphatic metastasis,radical prostatectomy for primary tumor renluction improves survival rates.