初始治療采用根治性切除術(shù)或近距離放射治療對高危前列腺癌患者預(yù)后的影響

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Effects of radical resection or brachytherapy as initial treatment on the prognosis of patients with high，risk prostate cancer

XU Yaozong1，DING Xuefei2，ZHU Liangyong2，ZHANG Jun1，SHI Guowei1

（1.Department of Urology，The Fifth Peoples Hospital of Shanghai，F(xiàn)udan University，Shanghai 200240；2.Department of Urology，Subei Peoples Hospital of Jiangsu Province，Yangzhou 225001，China）

ABSTRACT：ObjectiveTo investigate the effects of radical prostatectomy （RP） or brachytherapy （BT） on the prognosis of patients with high，risk prostate cancer as initial treatment，in order to provide a reference for the selection of clinical treatment options.MethodsThe clinical data of 133 191 patients diagnosed with high，risk prostate cancer and treated with RP or BT during 2005 and 2014 were extracted from the SEER database.The 5，year and 10， year cancer，specific survival （CSS） and overall survival （OS） were compared with K，M analysis and univariate and multivariate Cox regression.The clinical data of another 253 patients diagnosed with high，risk prostate cancer in Subei Peoples Hospital during 2015 and 2020 were collected，including 153 patients who received RP and 100 patients who received BT.The 5，year biochemical progress，free survival （bPFS） and CSS were compared with K，M analysis.ResultsUnivariate analysis of SEER data showed that BT was associated with a higher risk of death （HR=1.319，95%CI： 1.256-1.386，P<0.001）；age，marital status and TNM stage were associated with higher risk of death （P<0.001）.Multivariate analysis，adjusted for relevant variables，showed that BT did not result in a higher risk of death compared with RP （HR=0.964，95%CI：0.924-0.996，P=0.808）。（剩余8105字）