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目的通过评价内分泌疗法及内分泌联合TURP治疗新疆老年前列腺癌(PCa)的疗效并分析其主要预后因素,为老年PCa患者姑息性治疗的优化提供理论依据。方法回顾性分析155例老年(≥70岁)前列腺癌患者的临床病理资料,对各临床病理因素之间进行Spearman等级相关分析,应用Kaplan-Meier法计算生存率,对各临床病理因素分别进行单因素分析(log-rank检验),应用Cox比例风险模型进行多因素统计分析。结果不同治疗组的3年癌症特异性生存率分别为:内分泌治疗联合经尿道前列腺电切术(ET+TURP)78.9%、单一内分泌治疗组57%(P=0.059),汉族和其他少数民族患者的3年癌症特异性生存率分别为:71.6%和51.3%(P=0.062)。单因素分析结果示:患者确诊时年龄、ECOG体力状况(EPS)评分、直肠指检情况、肿瘤TNM分期、Gleason分级、ALP、HGB水平对老年前列腺癌预后的影响有统计学意义(P﹤0.05)。多因素分析结果示,年龄、TNM分期、Gleason分级、HGB是影响前列腺癌患者预后的重要因素。结论患者确诊时年龄、TNM分期、Gleason分级、HGB水平是影响老年前列腺癌患者内分泌治疗的独立预后因素,汉族和其他少数民族PCa患者之间无明显生存差异。接受ET治疗患者加TURP时可改善PCa所致的尿路梗阻症状,对生存率无负面影响。
Objective To evaluate the efficacy of endocrine therapy and endocrine combined with TURP in the treatment of elderly prostate cancer (PCa) in Xinjiang and to analyze its main prognostic factors, so as to provide a theoretical basis for the optimization of palliative treatment in elderly PCa patients. Methods The clinical and pathological data of 155 elderly patients (≥70 years) with prostate cancer were retrospectively analyzed. Spearman rank correlation analysis was performed among the various clinical and pathological factors. The Kaplan-Meier method was used to calculate the survival rate. The clinical and pathological factors were analyzed separately Factor analysis (log-rank test), using Cox proportional hazards model for multivariate statistical analysis. Results The 3-year cancer-specific survival rates of different treatment groups were: endocrine therapy combined with transurethral resection of the prostate (ET + TURP) 78.9%, single endocrine therapy group 57% (P = 0.059), Han and other ethnic minority patients The 3-year cancer-specific survival rates were 71.6% and 51.3%, respectively (P = 0.062). The results of univariate analysis showed that the prognosis of elderly patients with prostate cancer had statistical significance (P <0.05), the age at diagnosis, the score of ECOG physical status (EPS), the status of digital rectal examination, TNM stage of tumor, Gleason grade, ALP, ). Multivariate analysis showed that age, TNM stage, Gleason grade, HGB are important prognostic factors in patients with prostate cancer. Conclusion Age, TNM stage, Gleason grade and HGB level are the independent prognostic factors of endocrine therapy in elderly patients with prostate cancer. There is no significant difference in survival between Han and other ethnic minority PCa patients. ET-treated patients with TURP can improve PCa caused by urinary tract obstruction symptoms, no negative impact on survival.