文章：

在接受雄激素剥夺治疗的非转移性前列腺癌男性患者中，多发性或更严重级别的普遍性椎体骨折与更高的全因死亡率相关。

Multiple or More Severe Grade Prevalent Vertebral Fractures Are Associated with Higher All-Cause Mortality in Men with Nonmetastatic Prostate Cancer Receiving Androgen Deprivation Therapy

原文发布日期：25 June 2025

DOI: 10.3390/cancers17132131

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Prognostic information for nonmetastatic prostate cancer (nmPC) patients with prevalent vertebral fractures (PVFs) is very limited. Vertebral fractures can impair physical function, limit activities of daily living, and decrease quality of life. Prevention of vertebral fractures may be important to improve patient prognosis. This study aims to investigate the impact of the presence and severity of PVFs on overall survival in patients with nmPC undergoing androgen deprivation therapy (ADT).Methods: A total of 275 men (median age: 73 years) with nmPC who underwent ADT were studied retrospectively. The median observation period was 55 months. Variables included age, body mass index, T classification, N classification, Gleason score, and pretreatment serum prostate-specific antigen levels. PVF was diagnosed from the sagittal computed tomography images of Th1 to L5 before initiating ADT, and the severity was determined by the number of PVFs and the Semiquantitative (SQ) method. Hazard ratios and 95% confidence intervals for overall survival were calculated using the Cox proportional hazards model.Results: During the observation period, 30 patients died from all causes. Multivariate Cox regression analysis identified multiple PVFs and high-grade PVFs, as determined by the SQ method, as significant predictors of overall survival. The analysis utilized two adjustment models: one adjusted for age only and the other adjusted for age, Gleason score, and clinical T stage.Conclusions: Multiple PVFs and high-grade PVF determined by the SQ method prior to ADT initiation were associated with higher all-cause mortality in nmPC patients treated with ADT.

摘要翻译： 

背景/目的：目前关于非转移性前列腺癌患者合并椎体骨折的预后信息非常有限。椎体骨折可能损害身体功能、限制日常生活活动并降低生活质量。预防椎体骨折对改善患者预后具有重要意义。本研究旨在探讨椎体骨折的存在及其严重程度对接受雄激素剥夺治疗的非转移性前列腺癌患者总生存期的影响。 方法：本研究回顾性分析了275例接受ADT治疗的非转移性前列腺癌男性患者（中位年龄73岁）。中位观察期为55个月。研究变量包括年龄、体重指数、T分期、N分期、格里森评分以及治疗前血清前列腺特异性抗原水平。椎体骨折的诊断基于ADT治疗前胸1至腰5椎体矢状位计算机断层扫描图像，其严重程度通过骨折数量和半定量法进行评估。采用Cox比例风险模型计算总生存期的风险比及95%置信区间。 结果：观察期间共有30例患者死于各种原因。多变量Cox回归分析显示，经半定量法评估的多发性椎体骨折和高级别椎体骨折是总生存期的显著预测因子。分析采用两种调整模型：仅调整年龄的模型，以及同时调整年龄、格里森评分和临床T分期的模型。 结论：在ADT治疗前经半定量法评估的多发性椎体骨折和高级别椎体骨折，与接受ADT治疗的非转移性前列腺癌患者全因死亡率升高相关。

原文链接：

Multiple or More Severe Grade Prevalent Vertebral Fractures Are Associated with Higher All-Cause Mortality in Men with Nonmetastatic Prostate Cancer Receiving Androgen Deprivation Therapy