机器人辅助腹腔镜根治性前列腺切除术治疗寡转移性前列腺癌疗效分析  

Efficacy of robot-assisted radical prostatectomy for oligometastatic prostate cancer

作　　者：袁志 盛欧阳 刘启航 汪凯红 张亿达[1] 郭炬[1] 傅斌[1] 孙庭[1] 王共先[1] 曹润福[1] YUAN Zhi;SHENG Ouyang;LIU Qihang;WANG Kaihong;ZHANG Yida;GUO Ju;FU Bin;SUN Ting;WANG Gongxian;CAO Runfu(Department of Urology,The First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院泌尿外科,江西南昌330000

出　　处：《现代泌尿外科杂志》2021年第11期934-938,共5页Journal of Modern Urology

摘　　要：目的探讨机器人辅助腹腔镜根治性前列腺切除术(RARP)联合内分泌治疗寡转移性前列腺癌的安全性、可行性及临床疗效。方法回顾性分析2016年1月至2020年5月期间南昌大学第一附属医院泌尿外科收治的121例寡转移性前列腺癌患者,其中61例患者接受RARP联合内分泌治疗(联合治疗组),60例患者接受单纯内分泌治疗(单纯内分泌治疗组)。记录并比较两组患者的一般临床资料、治疗后前列腺特异性抗原(PSA)最低值、无去势抵抗性前列腺癌(CRPC)生存期以及联合治疗组术中及术后临床资料。结果联合治疗组较单纯内分泌治疗组患者更为年轻(P=0.001),其他一般临床资料两组比较,差异均无统计学意义。联合治疗组61例患者均顺利完成手术,术中有1例(1.6%)患者输血,术后3例(4.8%)患者出现轻度并发症,15例(24.6%)伴有淋巴结转移和41例(67.2%)标本切缘阳性。联合治疗组和单纯内分泌治疗组治疗后PSA最低值分别为0.05、0.09 ng/mL(P=0.001),CRPC进展率分别为32.8%、51.7%(P=0.035),无CRPC生存期(未达到vs.24个月,P=0.015)差异具有统计学意义。结论RARP联合内分泌治疗寡转移前列腺癌安全可行,术中术后未出现严重并发症,并且可以显著延长患者的无CRPC生存期,短期疗效确切。Objective To investigate the safety,feasibility and efficacy of robot-assisted radical prostatectomy(RARP)plus endocrine therapy in the treatment of oligometastatic prostate cancer.Methods Clinical data of 121 patients with oligometastatic prostate cancer admitted during Jan.2016 and May 2020 were retrospectively analyzed,including 61 who received RARP plus endocrine therapy(study group)and 60 who received endocrine therapy alone(control group).The general clinical data,prostate-specific antigen(PSA)nadir after treatment,castration-resistant prostate cancer(CRPC)free survival,and intraoperative and postoperative data were analyzed.Results The patients in the study group were younger(P=0.001),while there were no significant differences in other general clinical data.All 61 patients in study group completed the surgery successfully,and 1(1.6%)received blood transfusion during operation.After operation,3 patients(4.8%)had mild complications,15(24.6%)had lymph node metastasis and 41(67.2%)had positive resection margin.After treatment,PSA nadir was 0.05 and 0.09 ng/mL(P=0.001),CRPC progression rate was 32.8%and 51.7%(P=0.035)and CRPC-free survival was(not reached vs.24 months,P=0.015)in study group and control group,respectively.Conclusion RARP plus endocrine therapy is safe and feasible for oligometastatic prostate cancer,which causes few complications and can significantly prolong the CRPC-free survival of patients with good short-term efficacy.

关 键 词：前列腺癌 寡转移 根治性前列腺切除术 机器人辅助 内分泌治疗 

分 类 号：R737.25[医药卫生—肿瘤]