局部晚期攝護腺癌使用機器手臂根除性攝護腺併骨盆腔淋巴廓清手術治療預後分析
李柏毅、黃志平
中國醫藥大學附設醫院 泌尿部
Outcome of Robotic Radical Prostatectomy for Locally Advanced Prostate Cancer (≥ pT3 or N1)
Po-I,Li , Chi-Ping,Huang
China Medical University Hospital, Taichung, Taiwan
Purpose : Traditionally, The effectiveness of Radical prostatectomy (RP) alone for locally advanced prostate cancer is controversial owing to the increased complication rate and treatment related morbidity. However, technical advances and refinements in surgical techniques especially Robotic assisted radical prostatectomy (RARP) have enabled the outcomes for patients with high risk prostate cancer to be improved. Here, we share our outcome of RARP for locally advanced (≥pT3 and any pTN1M0) prostate cancer.
Materials and Methods: We retrospectively reviewed the patients who underwent RARP for locally advanced prostate cancer (PCa) in a single team within 2014 to 2019. Inclusion criteria was pathological T3a, T3b, T4 and N1, and exclusion criteria was metastasis. We analyzed Biochemical recurrence (BCR) free rate , rate of adjuvant radiotherapy and hormone therapy after operation. Other perioperative outcomes consisted of age, iPSA, operative time, blood loss and length of hospital stay. Biochemical recurrence was defined as two consecutive prostate-specific antigen values 0.2 ng/ml. Kaplan-Meier analyses assessed time to BCR and clinical recurrence.
Results: From 2014 to 2019,43 patients with locally advanced PCa underwent RARP and BPLND. The follow-up duration was until June 2020. Median follow-up duration was 24 months. Median age, iPSA , operative time, blood loss and length of hospital stay were 70-year-old , 27.51ng/mL , 306 min, 70 ml, and 7days. The BCR free rate was 61%. 4 patients received adjuvant radiotherapy and 12 patients received hormonal therapy.
Conclusion: The role of radical prostatectomy alone for locally advanced prostate cancer is controversial. However, it can decrease the tumor burden and allows the accurate and precise pathological staging with the need for subsequent treatment. Robotic assisted radical prostatectomy represents a well-standardized, safe, and oncological effective option in patients with locally advanced prostate cancer.