Eur Uro:中/高风险局限性前列腺癌最终治疗的种族差异:设施特征和社会经济特征的影响。

2017-08-04 fengxiangxin MedSci原创

过去十年来,前列腺癌 (PCa) 生存率在黑人与白人之间的差距扩大了。研究人员推测,这种差异可能部分归因于种族间最终治疗率(放射治疗或外科治疗)的差异。

过去十年来,前列腺癌 (PCa) 生存率在黑人与白人之间的差距扩大了。研究人员推测,这种差异可能部分归因于种族间最终治疗率(放射治疗或外科治疗)的差异。

为了确定黑人和白人在局部PCA最终治疗中使用的设备水平变化。研究者进行了大型回顾性队列研究。

根据国家癌症数据库的数据,研究者分别确定了,于2004年1月至2013年12月之间由组织活检确诊为局部中/高风险前列腺癌并在美国接受治疗的223873位白人和59262位黑人(年龄≥ 40岁)。

采用多水平logistic回归分析预测接受PCA最终治疗的可能性。在恰当的时候采用敏感度和亚组分析调整特定病人和设施水平差异。

在2004和2013之间,相比74%(n = 43662)的黑人接受最终治疗,83%(n = 185647)的白人接受了最终治疗。在此期间,最终治疗的总体率在白人(81% vs 83%,P < 0.001)和黑人(73% vs 75%,P = 0.001  )中均增加。

然而,39%的治疗设施的使用表明最终治疗率在白人男性中要显著高于黑人男性(只有1%的设施是倾向于黑人的)。该研究受到潜在的选择偏倚和效应修正的限制。

在调整社会人口统计因素和临床因素后,我们发现大多数设施都倾向用于白人的最终治疗中。因此,医务人员在为局限性PCa患者提供治疗方案建议时应当意识到这些继承偏见带来的影响。

原始出处:


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    2017-08-04 fengxiangxin301

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目前,通过前列腺特异性抗原(PSA)检测的前列腺癌治疗效果的比较仍然不确定。研究人员比较了主动监测,前列腺癌根治术,以及外照射放疗用于治疗临床局限性前列腺癌的治疗效果。在1999年至2009年间,共有82429名50至69岁的男性接受了PSA测试; 2664名参与者被诊断为局限性前列腺癌,共有1643名参与者同意接受随机化的主动监测(545人),外科手术(553),或放疗(545)。主要成果是平均

Eur Urol:不同的初次治疗方案对局限性前列腺癌患者术后生存质量影响的系统评价。

对于临床局限性前列腺癌,目前循证管理包括主动监测、手术、外放射治疗(EBRT)和近距离放疗。不同的治疗方式对生活质量(QOL)的影响是不确定的。