摘要
目的探讨≥80岁且健康状况良好的前列腺癌患者行腹腔镜前列腺根治术(LRP)的临床疗效及安全性。方法回顾性分析2016年8月-2020年3月于复旦大学附属浦东医院行LRP的18例≥80岁前列腺癌患者的临床资料。结果18例前列腺癌患者年龄80~86岁;术前血清总前列腺特异性抗原(tPSA)水平5.25~101.00 ng/mL;临床分期cT1N0M02例,cT2N0M012例,cT3N0M04例;Gleason评分≤6者4例,7分者9例,≥8分者5例。术后随访22~65个月,术后1、3、6个月及1年尿失禁率分别为50.00%(9/18)、33.33%(6/18)、16.67%(3/18)、5.56%(1/18),术后尿控恢复时间1~220 d;术后切缘阳性3例,3例出现生化复发。术后3、6个月及1年的国际前列腺症状评分(IPSS)均低于术前(P<0.05)。术后6个月前列腺治疗的功能评估(FACD-P)的总体健康评分高于术前(P<0.05)。结论对于经过筛选的≥80岁且健康状况良好的前列腺癌患者行腹腔镜前列腺癌根治术安全可行,临床疗效确切,但尚需进一步的长期随访和大样本量的前瞻性临床研究证实。
Objective To investigate the clinical efficacy and safety of laparoscopic radical prostatectomy in elderly prostate cancer patients aged≥80 years in good health.Methods A total of 18 octogenarian patients who underwent laparoscopic radical prostatectomy during Aug.2016 and Mar.2020 at our hospital were selected for retrospective analysis.Results The patients were 80 to 86 years old.The preoperative serum PSA was 5.25-101.00 ng/mL.There were 2 cases in stage cT1N0M0,12 in stagec T2N0M0 and 4 in stage cT3N0M.The Gleason score was≤6 in 4 cases,=7 in 9 cases,and≥8 in 5 cases.During the follow-up of 22 to 65 months,the rates of urinary incontinence at 1 month,3 months,6 months,and 1 year were 50.00%(9/18),33.33%(6/18),16.67%(3/18)and 5.56%(1/18),respectively.The postoperative urinary control recovery time was 1 to 220 days.Positive incision margin developed in 3 cases and biochemical recurrence occurred in 3 cases.The IPSS score at 3,6 months and 1 year after surgery were lower than these before surgery(P<0.05).The overall health score of the FACD-P scale at 6 months after surgery was higher than that before surgery(P<0.05).Conclusion For well selected octogenarian prostate cancer patients in good condition,laparoscopic radical prostatectomy is a feasible,safe and effective treatment option,but long-term follow-up and prospective clinical studies with large sample size are still needed to confirm its efficacy.
作者
李扬
张裕庆
方恺
梁胜杰
刘东
龚旻
朱汝健
LI Yang;ZHANG Yuqing;FANG Kai;LIANG Shengjie;LIU Dong;GONG Min;ZHU Rujian(Department of Urology,Pudong Hospital,Fudan University,Shanghai 201399,China)
出处
《现代泌尿外科杂志》
CAS
2023年第9期775-779,共5页
Journal of Modern Urology
基金
复旦大学附属浦东医院重点专科专病诊治中心项目(No.Zdzk2020-01)
复旦大学附属浦东医院重点学科项目(No.Zdxk2020-04)
复旦大学附属浦东医院院级人才项目(No.PY202001)。
关键词
前列腺癌
腹腔镜前列腺癌根治术
≥80岁
国际前列腺症状评分
总前列腺特异性抗原
prostate cancer
laparoscopic radical prostatectomy
80 years or older
International Prostate Symptom Score
total prostate specific antigen
