Purpose: Given the variable clinical course of prostate cancer and the limitations of current prognostic factors, this study was conducted to investigate the impact of a histologically overt stromal response (HOST-response) to prostate cancer on clinical outcomes after radical prostatectomy. Methods: This retrospective analysis utilized The Cancer Genome Atlas (TCGA) to evaluate data from individuals with a confirmed diagnosis of prostate cancer who underwent radical prostatectomy and had available pathology slides. These slides were assessed for the presence of a HOST-response, similar to desmoplasia. The primary endpoint was progression-free survival (PFS). A multivariable competing risk regression analysis was used to assess whether a significant association existed between HOST-response and PFS, adjusting for known prostate cancer prognostic factors. Results: Among the 348 patients analyzed, 166 (47.70%) demonstrated a HOST-response. After a median follow-up of 37.87 months (IQR: 21.20, 65.50), the presence of a HOST-response was significantly associated with a shorter PFS (SDHR, 2.10; 95% CI, 1.26 to 3.50;p= 0.004), after adjusting for covariates. Conclusions: HOST-response in prostate cancer patients treated with radical prostatectomy is significantly associated with reduced PFS, suggesting a potential benefit from adjuvant therapy and highlighting the need for further investigation in a prospective randomized clinical trial.
目的：鉴于前列腺癌临床病程的多样性及现有预后因素的局限性，本研究旨在探讨组织学上明显的间质反应（HOST-response）对根治性前列腺切除术后临床结局的影响。方法：本回顾性分析利用癌症基因组图谱（TCGA）数据库，纳入经确诊为前列腺癌、接受根治性前列腺切除术且病理切片可用的患者数据。对这些切片进行评估，检测是否存在类似促结缔组织增生特征的HOST-response。主要终点为无进展生存期（PFS）。采用多变量竞争风险回归分析，在调整已知前列腺癌预后因素后，评估HOST-response与PFS之间是否存在显著关联。结果：在分析的348例患者中，166例（47.70%）表现出HOST-response。中位随访37.87个月（四分位距：21.20, 65.50）后，经协变量调整，HOST-response的存在与较短的PFS显著相关（次分布风险比，2.10；95%置信区间，1.26至3.50；p=0.004）。结论：接受根治性前列腺切除术的前列腺癌患者中，HOST-response与PFS降低显著相关，提示辅助治疗可能带来潜在获益，并强调需在前瞻性随机临床试验中进一步验证。
肿瘤(癌症)患者之家