内分泌治疗联合机器人辅助腹腔镜根治性前列腺切除术治疗寡转移前列腺癌的临床研究  

Endocrine therapy combined with robot-assisted laparoscopic radical prostatectomy in the treatment of oligometastatic prostate cancer

作　　者：吴建红 陈之灏 孙可宁 何奕俊 盛璐 Wu Jianhong;Chen Zhihao;Sun Kening;He Yijun;Sheng Lu(Department of Urology,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院泌尿外科,上海200040

出　　处：《微创泌尿外科杂志》2022年第2期87-90,共4页Journal of Minimally Invasive Urology

摘　　要：目的:探讨内分泌治疗联合机器人辅助腹腔镜根治性前列腺切除术在寡转移前列腺癌中临床应用,以期为前列腺癌骨转移患者的治疗提供更多参考方案。方法:回顾性分析33例前列腺癌骨转移患者(骨转移病灶≤3处)的临床资料,根据治疗方式不同将患者分为雄激素剥夺治疗联合机器人辅助腹腔镜根治性前列腺切除术组(联合治疗组,15例)和单纯内分泌治疗组(单纯治疗组,18例)。比较两组患者随访期间的血清PSA水平、临床进展等情况。结果:联合治疗组较单纯治疗组患者更年轻(P<0.05),其他基线资料比较差异均无统计学意义。联合治疗组15例患者均顺利完成手术,2例伴有淋巴结转移,13例标本切缘阳性。联合治疗组和单纯治疗组治疗后PSA最低值分别为0.03μg/L、0.07μg/L,寡转移前列腺癌的进展率分别为31.8%、54.2%,差异具有统计学意义(P<0.05)。结论:原发灶减瘤根治性前列腺切除术联合内分泌治疗寡转移前列腺癌安全可行,并且可以显著延长患者的无进展生存期,短期疗效确切,可作为寡转移前列腺癌治疗的新手段。Objective:To investigate the clinical application of endocrine therapy combined with robotic-assisted laparoscopic radical prostatectomy in oligometastatic prostate cancer in order to provide more reference for the treatment of prostate cancer patients with bone metastases.Methods:The clinical data of 33 prostate cancer patients with bone metastases(bone metastases≤3)were retrospectively analyzed.According to different treatments,the patients were divided into endocrine therapy combined with robot-assisted laparoscopic radical prostatectomy group(combination therapy group,n=15)and endocrine therapy alone group(simple treatment group,n=18).The serum PSA level and clinical progress during the follow-up period were compared between the two groups.Results:The patients in the combined treatment group were younger than those in the simple treatment group(P<0.05),and there was no significant difference in other baseline data.In the combined treatment group,all 15 patients successfully completed the operations,2 patients had lymph node metastasis and 13 samples had positive margins.The lowest value of PSA after treatment in the combined treatment group and the simple treatment group was 0.03 and 0.07μg/L,respectively,and the progression rates of castration-resistant prostate cancer were 31.8%and 54.2%,respectively,and the difference was statistically significant(P<0.05).Conclusion:Primary tumor debulking radical prostatectomy combined with endocrine therapy for oligometastatic prostate cancer is safe and feasible.There are no serious complications during and after operation,and it can significantly prolong the progression-free survival of patients,and the short-term curative effect is definite.

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]