摘要
前列腺癌是男性常见癌症之一。在世界范围内,超过半数以上的新发前列腺癌病例为Gleason评分3+3=6(GS6)的低级别前列腺癌。绝大多数GS6前列腺癌预后良好,极少出现远处转移,国际上首选的治疗和管理方法为主动监测。近年来,泌尿外科领域部分学者基于GS6前列腺癌发生的普遍性、极低的转移率、极佳的预后、接近于癌前病变的筛查方式和治疗管理模式,认为其不应再被称为癌症,将其更名为非癌症可以缓解患者的焦虑情绪,减少因过度治疗带来的毒副作用和经济负担。另有学者提出反对的观点,认为是否会出现转移,不应作为判断肿瘤是否为恶性的唯一标准;在临床实践中,GS6前列腺癌患者存在术后病理升级的可能,应该综合多种临床因素来判定肿瘤的性质和危险程度;此外,对GS6前列腺癌的更名可能造成患者的依从性降低,所以不应该对其进行重新命名。本文对近期相关观点和论据进行总结,并对管理策略进行综述。
Prostate cancer is one of the most common cancers in men.Worldwide,more than half of all new prostate cancer cases are low-grade prostate cancers with a Gleason score of 3+3=6(GS6).GS6 prostate cancer has a good prognosis,with very few distant metastases,and the preferred treatment and management approach abroad is active surveillance.In recent years,some scholars within the field of urology have argued that GS6 prostate cancer should no longer be called cancer based on its prevalence,extremely low metastasis rate,excellent prognosis,near precancerous screening and treatment management modalities,and that renaming it as non-cancerous would alleviate patient anxiety and reduce the toxic side effects and financial burden associated with overtreatment.Others have argued against it,arguing that whether metastasis will occur should not be the only criterion to determine whether a tumor is malignant or not.In clinical practice,GS6 prostate cancer patients have the possibility of postoperative pathological upgrading,and multiple clinical factors should be integrated to determine the nature and risk degree of the tumor.In addition,renaming of GS6 prostate cancer may result in reduced patient compliance,so it should not be renamed.This article summaries recent relevant views and arguments and reviewed the management strategies of GS6 prostate cancer.
作者
马金铎
曹煜东
王硕
杜鹏
Ma Jinduo;Cao Yudong;Wang Shuo;Du Peng(Department of Urology,Peking University Cancer Hospital and Beijing Institute of Cancer Control,Key Laboratory of Pathogenesis and Translational Research of Malignant Tumors,Ministry of Education,Beijing 100142,China)
出处
《泌尿外科杂志（电子版）》
2022年第4期9-14,共6页
Journal of Urology for Clinicians(Electronic Version)
基金
首都卫生发展科研专项项目(2022-1G-1021)
