目的 探讨前列腺癌家族史(family history of prostate cancer，FHPC)和其他癌症家族史(family history of cancer，FHC)对腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy，LRP)后患者预后的影响。方法 应用前瞻性研究方法。选取2018年7月—2020年6月永煤集团总医院行腹腔镜下PCa根治术的患者414例。在PCa患者LRP后对其进行随访。根据其FHPC、FHC状况进行分组。对比分析FHPC和非FHPC、FHC和非FHC患者的3年预后差异。应用Cox回归探讨FHPC和FHC对PCa患者预后的影响。结果 414例患者术后3年生化复发32例(7。73％);术后3年全因死亡29例(7。00％);术后3年PCa特异性死亡22例(5。31％)。经比较，仅非FHC组和FHC的生化复发率有显著性差异(P＜0。05)，FHC组明显为高。Cox回归结果:FHPC以及年龄(≥60岁)、术前PSA(≥20 μg/L)、术前Gleason评分(≥8分)、TNM分期(T2)，均是促使生化复发的危险影响因素(P＜0。05);年龄(≥60岁)、术前Gleason评分(≥8分)、术前PSA(≥20 μg/L)、TNM分期(T2)、有精囊侵犯、手术切缘阳性，均是促使全因死亡的危险影响因素(P＜0。05);前列腺体积(≥35 mL)、肿瘤直径(≥4。89 cm)、TNM分期(T2)、分化程度(低中分化)，均是促使术后PCa特异死亡的危险影响因素(P＜0。05)。结论 FHPC可增加PCa患者LRP后的生化复发率。
Impact of family history of prostate cancer and family history of other cancers on prognosis of patients after laparoscopic radical prostatectomy
Objective The study aims to investigate the impact of family history of cancer(FHC)and family history of prostate cancer(FHPC)on the prognosis of patients after laparoscopic radical prostatectomy(LRP).Methods Prospective research methods were applied.Follow up PCa patients after LRP.Group them based on their FHPC and FHC status.Comparative analysis of the 3-year prognosis differences between FHPC and non FHPC,FHC and non FHC patients.Applying Cox regression to explore the impact of FHPC and FHC on the prognosis of PCa pa-tients.Results Among 414 patients,32(7.73％)had biochemical recurrence 3 years after surgery;29 cases(7.00％)died from all causes within 3 years after surgery;22 cases(5.31％)of PCa specific deaths occurred 3 years after surgery.After comparison,there was a significant difference(P＜0.05)in the biochemical recurrence rate between the non FHC group and FHC group,while the FHC group was significantly higher.Cox regression results:FH-PC,age(≥60 years old),preoperative PSA(≥20 μg/L),preoperative Gleason score(≥8 points),and TNM stage(T2)were all risk factors that promote biochemical recurrence(P＜0.05);Age(≥60 years old),preoperative Glea-son score(≥8 points),preoperative PSA(≥20 μg/L),TNM staging(T2),presence of seminal vesicle invasion,and positive surgical margin were all risk factors that promote all-cause mortality(P＜0.05);Prostate volume(≥35 mL),tumor diameter(≥4.89 cm),TNM staging(T2),and degree of differentiation(low to moderate differentia-tion)were all risk factors for postoperative PCa specific death(P＜0.05).Conclusion FHPC can increase the bio-chemical recurrence rate of PCa patients after LRP.
NETL
NSTL
万方数据
