文章：

欧洲泌尿外科协会生化复发风险分类与前列腺特异性抗原动力学在寡复发前列腺癌的PSMA放射引导手术患者选择中无价值

EAU Biochemical Recurrence Risk Classification and PSA Kinetics Have No Value for Patient Selection in PSMA-Radioguided Surgery (PSMA-RGS) for Oligorecurrent Prostate Cancer

原文发布日期：16 October 2023

DOI: 10.3390/cancers15205008

类型: Article

开放获取: 是

英文摘要：

Objective: To assess the influence of biochemical recurrence (BCR) risk groups and PSA kinetics on the outcomes of radioguided surgery against prostate-specific membrane antigen (PSMA-RGS). Currently, neither BCR risk group nor PSA doubling time (PSA-DT), or PSA velocity (PSA-V) are actively assigned or relevant for counseling prior to PSMA-RGS. Methods: We retrospectively analyzed PSMA-RGS cases for oligorecurrent prostate cancer between 2014 and 2023. BCR risk groups, PSA-DT, and PSA-V were analyzed as predictors for complete biochemical response (cBR, PSA < 0.2 ng/mL), BCR-free, and therapy-free survival (BCRFS, TFS). Results: Of 374 included patients, only 21/374 (6%) and 201/374 (54%) were classified as low- and high-risk BCR (no group assignment possible in 152/374, 41%). A total of 13/21 (62%) patients with low- and 120/201 (60%) with high-risk BCR achieved cBR (p= 1.0). BCR classification was no predictor for BCRFS (HR:1.61, CI: 0.70–3.71,p= 0.3) or subsequent TFS (HR:1.07, CI: 0.46–2.47,p= 0.9). A total of 47/76 (62%) patients with PSA-DT ≤ 6 mo and 50/84 (60%) with PSA-DT > 6 mo achieved cBR (p= 0.4). PSA-DT was not associated with cBR (OR: 0.99, CI: 0.95–1.03,p= 0.5), BCRFS (HR: 1.00, CI: 0.97–1.03,p= 0.9), or TFS (HR: 1.02, CI: 0.99–1.04,p= 0.2). Consistent negative findings were recorded for PSA-V. Conclusions: The BCR risk groups and PSA kinetics do not predict the oncological success of PSMA-RGS performed at low absolute PSA values. Indolent low-risk BCR is rarely treated by PSMA-RGS.

摘要翻译： 

目的：评估生化复发（BCR）风险分组及前列腺特异性抗原（PSA）动力学对前列腺特异性膜抗原放射引导手术（PSMA-RGS）疗效的影响。目前，在PSMA-RGS术前咨询中，BCR风险分组、PSA倍增时间（PSA-DT）及PSA速率（PSA-V）均未被常规纳入评估体系。方法：回顾性分析2014年至2023年间接受PSMA-RGS治疗的寡复发前列腺癌病例。以BCR风险分组、PSA-DT及PSA-V作为预测指标，分析其与完全生化缓解（cBR，PSA < 0.2 ng/mL）、无生化复发生存期（BCRFS）及无治疗生存期（TFS）的关联性。结果：在纳入的374例患者中，仅21例（6%）被划分为低危BCR组，201例（54%）为高危BCR组（152例患者无法进行风险分组，占41%）。低危组中13例（62%）与高危组中120例（60%）患者达到cBR（p=1.0）。BCR风险分组对BCRFS（HR:1.61，CI:0.70–3.71，p=0.3）及后续TFS（HR:1.07，CI:0.46–2.47，p=0.9）均无预测价值。PSA-DT ≤ 6个月组中47/76例（62%）与PSA-DT > 6个月组中50/84例（60%）患者达到cBR（p=0.4）。PSA-DT与cBR（OR:0.99，CI:0.95–1.03，p=0.5）、BCRFS（HR:1.00，CI:0.97–1.03，p=0.9）及TFS（HR:1.02，CI:0.99–1.04，p=0.2）均无显著关联。PSA-V的分析结果与此一致。结论：在PSA绝对值较低时实施的PSMA-RGS，其肿瘤学疗效不受BCR风险分组及PSA动力学参数影响。惰性低危BCR患者极少接受PSMA-RGS治疗。

原文链接：

EAU Biochemical Recurrence Risk Classification and PSA Kinetics Have No Value for Patient Selection in PSMA-Radioguided Surgery (PSMA-RGS) for Oligorecurrent Prostate Cancer