前列腺癌根治术后膀胱颈部与精囊侵犯的预后比较  

Prognosis comparison of bladder neck with seminal vesicle invasion after radical operation of prostate carcinoma

作　　者：沙建军[1] 吴小荣[1] 潘家骅[1] 张连华[1] 宣寒青[1] 李东[1] 薛蔚[1] 薄隽杰[1] 刘东明[1] 黄翼然[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,200001

出　　处：《中华老年医学杂志》2012年第11期938-940,共3页Chinese Journal of Geriatrics

基　　金：国家自然科学基金（91129725）

摘　　要：目的比较前列腺癌根治性切除术后膀胱颈部与精囊侵犯患者的预后。方法回顾性分析2002年1月至2008年12月我院接受耻骨后前列腺癌根治性切除术的42例患者，年龄59～78岁，平均70．3岁。42例患者分为pT4a组（膀胱颈部侵犯的患者17例）和pT3h组（单侧或双侧精囊侵犯的患者25例）。术后分别采取辅助治疗，定期门诊随访，以术后血清前列腺特异抗原（PSA）连续2次大于0．2pg／L定义为生化复发，术后随访至发生生化复发的时间或随访至截止日期未发生生化复发的时间定义为无生化复发生存时间。结果两组患者术后随访50～122个月，17．6％（3／17）膀胱颈部侵犯者术后发生生化复发，24．0％（6／25）精囊侵犯者发生生化复发，两组比较差异无统计学意义（P〉0．05）。结论前列腺癌根治术后辅助内分泌治疗能明显延长膀胱颈部侵犯与精囊侵犯的前列腺癌患者无生化复发生存期，但两组无生化复发生存率无差别，可考虑降低膀胱颈部侵犯在TNM系统中的分期。Objective To assess the prognosis of patients with bladder neck （BN） involvement in radical prostatectomy specimens and compare it with patients with seminal vesicle invasion （SVI）. Methods From January 2002 to December 2008, 42 patients with prostate carcinoma who underwent radical prostatectomy were analyzed retrospectively. The mean age was 70.3 years （range 59-78 years）. The patients were divided into two groups according to 2002 TNM system： pT4agroup （bladder neck invasion） with 17 cases and pT3bgroup （unilateral or bilateral seminal vesicle invasion） with 25 cases. Postoperative outpatients were followed-up on a regular basis, two consecutive postoperative serums PSA greater than 0.2 μg/L defined as a biochemical recurrence. The postoperative follow-up to the time of biochemical recurrence or follow-up to the deadline without biochemical recurrence were defined as biochemical recurrence -free survival time. Results All patients were followed up for 50-122 months. The patients with BN involvement 17.6% （3/17） had biochemical recurrence, whereas seminal vesicle invasion 24.0% （6/25）, there was no statistical significance between the two groups （P〉0. 05）. Conclusions Postoperative adjuvant therapies can improve the biochemical recurrence-free survival. In this study, the prognosis of pT4a and pTab group is similar. A conceivable down staging of BN involvement in the TNM staging system should be considered.

关 键 词：前列腺肿瘤 肿瘤转移 预后 

分 类 号：R737.25[医药卫生—肿瘤]