Clinical Analysis Of 111 Cases Of Prostate Cancer

Objective:To study the relationships between prognosis of patients with PCa with age, PSAD, Gleason score, clinical stage and bone metastasis.Methods:Clinical data of 111 PCa patients were reviewed, who were diagnosed by pathological examination in our hospital between 2005-6 and 2009-1, and had complete informations of PSA, ECT, CT / MRI, X ray, B-Ultrasound of prostate, TNM stage and PSAD. Prognosis of 69 patients was followed up by telephone or mail and then a survival analysis was done. End point of following-up is: 1. Died from prostate cancer or prostate cancer-related complications. 2. Died from other reasons. Follow-up period was that patients reached the end point of follow-up or 2010-2-1. The relationships between clinical factors were used SPERAMAN analysis ; The patients were divided into death group and non-death group; Differences of clinical factors between the two groups were compared by T test and Mann-Whitney U test. The relationship between each factor with prognosis was studied by Cox proportional hazards models.Results :The average age of the patients was 73.14 years (56-90 years), with an average follow-up period of 24 months (1-55 months), 57 patients responded to the follow-up, 12 patients were lost(17.4%: 12/69), 23 patients reached endpoint. Age was positively correlated with T (clinical stage) (rs=0.287, P <0.01), PSAD was positively correlated with T (rs=0.321, P <0.01) and Gleason score (rs=0.327, P <0.01). T was positively correlated with Gleason score (rs=0.250, P <0.01). Age was not significantly correlated with Gleason score (P> 0.05). Between Death group and non-death group, bone metastasis, clinical stage, PSAD and Gleason score were significantly different (P<0.05). With Gleason score 7 as a cutoff point, the patients were devided into > 7 group and <= 7 group, there was a significantly different mortality between them (P= 0.046: P <0.05). The patients were devided into different groups by PSAD level of 3 ng/mL·cm~3, mortality rates were significantly different (P<0.01). Life table method of survival analysis showed that the cumulative survival rates were significant different between PSAD level <= 3 ng/mL·cm~3 group with> 3 ng/mL·cm~3 group (P <0.01). Cox proportional hazards models showed that bone metastases(RR=3.969, P<0.05), PSAD(RR=3.979, P<0.05), clinical stage(RR=1.963, P<0.05) were risk factors of prognosis of patients with PCa; 1, 2, 3, 4-year cumulative survival rates were 86%, 64%, 54%, 33% in PCa patients, respectively. The median survival time was 43.36 months.Conclusions:Prognosis of PCa patients are certainly correlated with bone metastasis, clinical stage, PSAD , Gleason score; There is no significant correlation between age and the prognosis of patients witn PCa. Bone metastases, PSAD and clinical stage are risk factors for prognosis of patients with PCa .Taking PSAD level =3 ng/mL·cm~3 as a cut off point, the cumulative survival rate of >3 group is significantly lower than that of <=3 group (P <0.05) . PSAD may play a role in determining the prognosis of PCa patients.