腹腔鏡攝護腺根除性手術於術前攝護腺特異抗原超過五十攝護腺癌之治療經驗
李彥羲、凌永耀、陳忠賢、陳毓騏、林嘉祥
1義大醫療財團法人義大醫院泌尿部
2義守大學學士後醫學系國際學生專班
Outcome of laparoscopic radical prostatectomy with intended wide resection in prostate cancer patients with a preoperative serum PSA level > 50 ng/ml: A single surgeon experience
Yen-Hsi Lee1, Henry Y. Lin1, Chung-Hsien Chen1, Yu-Chi Chen1, Victor C. Lin1, 2
1Department of Urology, E-Da Hospital, Kaohsiung, Taiwan;
2School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
Purpose: To assess the outcome of prostate cancer patients with preoperative prostate-specific antigen (PSA) levels over than 50 ng/ml who were treated with laparoscopic radical prostatectomy with intended wide resection.
Materials and Methods: Total twelve patients from Jan. 2007 to Dec. 2015 with prostate cancer who underwent laparoscopic radical prostatectomy with intended wide resection had an initial PSA level over than 50 ng/ml were included in this study. Overall survival, cancer-specific survival and, peri-operative and post-operative parameters and pathologic features, percentage of neoadjuvant hormone therapy, adjuvant therapy were analyzed.
Results: The mean serum PSA level was 89.4 (50.6-191.0) ng/ml. Four patients (33%) received neoadjuvant hormone therapy. Two patients were classified as stage pT2, three as pT3a, four as pT3b and three as pT4. Three patients had pelvis lymph node metastasis. Six patients (50%) received adjuvant hormone therapy. Three patients had PSA failure and two received salvage radiotherapy. Overall survival and cancer-specific survival were 100% and 100%, respectively, during mean follow up of 3.9 years. Continence rate was 91.7% and average recovery time was 62 (7-287) days. Potency rate was 8.3%.
Conclusion: The study showed a relatively feasible outcome for clinically non-metastatic but locally advanced prostate cancer with PSA levels over than 50 ng/ml treated by laparoscopic radical prostatectomy with intended wide resection.