文章：

机器人辅助根治性前列腺切除术后首月前列腺特异性抗原下降率是生化复发的及时预测因子

Prostate-Specific Antigen Decline Rate in the First Month Is a Timely Predictive Factor for Biochemical Recurrence After Robot-Assisted Radical Prostatectomy

原文发布日期：12 March 2025

DOI: 10.3390/cancers17060961

类型: Article

开放获取: 是

英文摘要：

Objectives: We attempt to assess whether prostate-specific antigen decline rate in the first month (PSADR1M = postoperative PSA in the first month/initial PSA) acts as a predictor for biochemical recurrence (BCR) and to evaluate other preoperative and postoperative variables that may predict BCR following robot-assisted laparoscopic prostatectomy (RARP).Method: Based on the D’Amico risk classification system, 777 patients who underwent RARP for localized prostate cancer were classified into a low/intermediate-risk group (n= 435) and a high-risk group (n= 342). The predictors of BCR were identified by univariate and multivariate logistic regression analyses. The area under the curve (AUC) and optimal cutoff values of PSADR1M were determined by receiver operating characteristic (ROC) analysis. Kaplan–Meier curves for biochemical recurrence-free survival (BRFS) rates were stratified by optimal cutoff values of PSADR1M.Results: Effective predictors of BCR in the entire cohort included pT3 (p< 0.001), pathological Grade Group (pGG3, pGG4+5) compared to pGG1+2 (p< 0.001,p= 0.017), positive surgical margins (PSM) (p< 0.001), seminal vesicle invasion (SVI) (p= 0.006), and PSADR1M ≥ 0.62% (p< 0.001). ROC analysis showed that PSADR1M as a predictor for BCR had an AUC of 0.762 for the whole cohort, and 0.821 for the high-risk group, respectively. The optimal cutoff values of PSADR1M were 0.62% in the whole cohort, and 0.68% in high-risk group.Conclusions: As an effective predictor of BCR, PSADR1M can assess the tumor status of prostate cancer patients intuitively and effectively after RARP, especially in the high-risk group.

摘要翻译： 

目的：本研究旨在评估术后第一个月前列腺特异性抗原下降率（PSADR1M = 术后第一个月PSA/初始PSA）能否作为机器人辅助腹腔镜前列腺切除术（RARP）后生化复发（BCR）的预测指标，并探讨其他可能预测BCR的术前及术后变量。方法：基于D'Amico风险分层系统，将777例因局限性前列腺癌接受RARP的患者分为低/中危组（n=435）和高危组（n=342）。通过单因素及多因素逻辑回归分析确定BCR的预测因素。采用受试者工作特征（ROC）曲线分析确定PSADR1M的曲线下面积（AUC）及最佳截断值。根据PSADR1M最佳截断值对无生化复发生存（BRFS）率进行Kaplan-Meier曲线分层分析。结果：全队列中BCR的有效预测因素包括：pT3分期（p<0.001）、病理分级分组（与pGG1+2相比，pGG3为p<0.001，pGG4+5为p=0.017）、手术切缘阳性（PSM）（p<0.001）、精囊侵犯（SVI）（p=0.006）以及PSADR1M ≥ 0.62%（p<0.001）。ROC分析显示，PSADR1M作为BCR预测指标，在全队列中的AUC为0.762，在高危组中为0.821。PSADR1M的最佳截断值在全队列中为0.62%，在高危组中为0.68%。结论：作为BCR的有效预测指标，PSADR1M能直观有效地评估RARP术后前列腺癌患者的肿瘤状态，尤其在高危人群中具有重要应用价值。

原文链接：

Prostate-Specific Antigen Decline Rate in the First Month Is a Timely Predictive Factor for Biochemical Recurrence After Robot-Assisted Radical Prostatectomy