摘要
目的探讨前列腺癌根治术联合新辅助内分泌治疗在局部晚期前列腺癌(locally advanced prostate cancer,LAPC)中的应用效果。方法回顾性分析哈尔滨医科大学附属第一医院2015年1月~2018年7月收治的52例前列腺癌患者的临床资料。根据治疗方式的不同分为实验组(26例)和对照组(26例)。实验组病理穿刺结果确定后,由医师指导进行新辅助内分泌治疗,待治疗3~6月以后,再次行前列腺核磁检查,有明显肿瘤体积缩小时,继而行腹腔镜前列腺癌根治术。对照组在穿刺结果出来3~4周后直接行腹腔镜下前列腺癌根治术。观察两组患者的治疗后手术总时间、术中出血量、淋巴结清扫时间、病理切缘阳性率、前列腺特异性抗原(prostate specific antigen,PSA)变化情况、术后并发症、1年复发及2年复发率的变化。结果实验组在手术总时间、术中出血量、淋巴结清扫时间、病理切缘阳性率、血清PSA变化情况及术后并发症方面上均优于对照组,差异有统计学意义(P<0.05);两组的1年复发率及2年复发率差异无统计学意义(P>0.05)。结论建议在LAPC行腹腔镜前列腺癌根治术前使用新辅助内分泌治疗。
Objective To explore the application of radical prostatectomy combined with neoadjuvant endocrine therapy in locally advanced prostate cancer(LAPC).Methods The clinical data of 52 prostate cancer patients admitted to the First Affiliated Hospital of Harbin Medical University Medical University from January 2015 to July 2018 were retrospectively analyzed.They were divided into experimental group(26 cases)and control group(26 cases)according to different treatment methods.After the results of the pathological puncture in the experimental group were confirmed,neoadjuvant endocrine therapy was conducted under the guidance of physicians.After 3~6 months of treatment,prostate MRI was performed again.When the tumor volume was significantly reduced,laparoscopic radical prostatectomy was followed.The control group underwent laparoscopic radical prostatectomy directly 3~4 weeks after the puncture results came out.The total operation time,intraoperative blood loss,lymph node dissection time,pathological resection margin positive rate,serum prostate specific antigen(PSA)changes,postoperative complications,one-year recurrence and change in recurrence rate in two years were observed.Results The experimental group was better than the control group in terms of total operation time,intraoperative blood loss,lymph node dissection time,pathological resection margin positive rate,serum PSA changes and postoperative complications,and the difference was statistically significant(P<0.05);There was no significant difference in the one-year and two-year recurrence rates between the two groups(P>0.05).Conclusion Neoadjuvant endocrine therapy is recommended before LAPC for radical prostatectomy.
作者
程杨杨
杜萌
王涌泉
安瑞华
CHENG Yang-yang;DU Meng;WANG Yong-quan;AN Rui-hua(Department of Urology Surgery,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《哈尔滨医科大学学报》
CAS
2021年第6期598-602,共5页
Journal of Harbin Medical University
关键词
前列腺癌
局部晚期前列腺癌
腹腔镜前列腺癌根治术
新辅助内分泌治疗
prostate cancer
locally advanced prostate cancer
laparoscopic radical prostatectomy
neoadjuvant endocrine therapy
