摘要
目的腹腔镜扩大盆腔淋巴结清扫联合前列腺癌根治术(ePLND+LRP)治疗的局部晚期前列腺癌(LAPC)患者的长期随访结果报告尚不多见。本研究报告本中心246例LAPC接受ePLND+LRP治疗的10年随访结果。方法收集2006年10月到2020年10月期间在我院接受ePLND+LRP治疗的246例LAPC患者资料,统计手术时间、失血量、住院时间和围手术期并发症、肿瘤学结果和辅助治疗效果。结果中位年龄70(65~74)岁;中位PSA为24(10~60)ng/ml。中位手术时间、失血量和住院时间分别为217 min,170 ml,7 d。病理分期pT_(2)有28例(11.4%),pT_(3a)117例(47.6%),pT_(3b)92例(37.4%),pT_(4)有9例(3.7%)。中位淋巴结清扫数目为21枚(13~27),中位阳性淋巴结数目为2(1~3)。淋巴结阳性和手术切缘阳性病例分别为48例(19.5%)和31例(12.6%)。38例(15.4%)出现并发症,其中17例(6.9%)为ClavienⅠ级,19例(7.7%)为ClavienⅡ,2例(0.8%)为ClavienⅢ。中位随访时间127.8个月。10年无生化复发率和无转移生存率分别为58.5%(144/246)和73.6%(181/246),肿瘤特异性生存率,总体生存率分别为91.6%以及85.3%。术后1年控尿率为96.7%。随访期内接受辅助放疗,内分泌治疗、挽救性淋巴结清扫和局部治疗分别为23例(9.3%)、219例(89.0%)、59例(24.0%)和7例(2.8%)。结论ePLND+LRP结合辅助治疗措施治疗LAPC的10年肿瘤根治效果满意。
Objective The long-term follow-up results of patients with locally advanced prostate cancer(LAPC)treated with laparoscopic extensive pelvic lymph node dissection combined with radical prostatectomy(ePLND+LRP)are still rare.This study reports 246 LAPC patients treated with ePLND+LRP from 2006 to 2020 in the Third Affiliated Hospital of Sun Yat-sen University.Methods From October 2006 to October 2020,246 LAPC patients with ePLND+LRP were enrolled in this study.The operation time,blood loss,duration of hospital stay and complications,oncology results,and adjuvant treatments occurred within 30 days after surgery were collected.Results The median age was 70(65-74)years;the median PSA was 24(10-60)ng/ml.The median operation time,blood loss,and hospital stay were 217 minutes,170 ml,and 7 days,respectively.In pathological staging,there were 28 cases(11.4%)in pT_(2),117 cases(47.6%)in pT_(3a),92 cases(37.4%)in pT_(3b),and 9 cases(3.7%)in pT_(4).The median number of lymph nodes dissected was 21(13-27),and the median number of positive lymph nodes was 2(1-3).48(19.5%)and 31(12.6%)patients had positive lymph nodes and positive surgical margins.Thirtyeight(15.4%)patients experienced complications,of which 17 cases(6.9%)were classified as ClavienⅠ,19 cases(7.7%)were classified as ClavienⅡ,and 2 cases(0.8%)were classified as ClavienⅢ.The median follow-up time was 127.8 months,during the follow-up period,23(9.3%),219(89.0%),59(24.0%),and 7(2.8%)patients received adjuvant radiotherapy(RT),hormone therapy(HT),and salvage lymph node dissection(s LND),salvage local treatment.The 10-year BCR-free survival and metastasis-free survival(MFS)rates were 58.5%(144/246)and 73.6%(181/246),respectively.Cancer-specific survival(CSS)and overall survival(OS)were 91.6%and 85.3%,respectively.The rate of urinary control at one year after operation was 96.7%.Conclusion The e PLND+LRP treatment of LAPC has fewer complications and a good tumor control effect.It is safe and effective as the initial treatment of LAPC.
作者
王喻
孙卓伦
李腾成
刘小彭
狄金明
李科
胡成
方友强
李辽源
高新
温星桥
Wang Yu;Sun Zhuolun;Li Tengcheng;Liu Xiaopeng;Li Ke;Hu Cheng;Fang Youqiang;Li Liaoyuan;Di Jinming;Gao Xin(Department of Urology,the Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2022年第2期101-105,共5页
Chinese Journal of Endourology(Electronic Edition)
基金
2017年国家重点研发计划(2017YFC0908004)
2017年国家自然科学基金面上项目(8177102020)
2017年广东省科技计划项目(2017B020227008)
关键词
长期随访
肿瘤学结果
前列腺癌
前列腺切除术
淋巴结清扫
Long-term follow-up
Oncology results
Prostate cancer
Prostatectomy
Lymph node dissection
