[如何以独特的方式呈现根治性前列腺切除术后的肿瘤学和功能结果]

[How to present in a unique fashion the oncologic and functional results after radical prostatectomy].

作者信息

Salomon Laurent, Saint Fabien, Anastasiadis Aristotelis G, Sebe Philippe, Chopin Dominique, Abbou Clément-Claude

机构信息

Service d'Urologie, Hôpital Henri Mondor, AP-HP, EMI 03-37, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil.

出版信息

Prog Urol. 2003 Sep;13(4):624-8.

PMID:14650294

Abstract

INTRODUCTION

The results of radical prostatectomy (cancer control, continence and sexual potency) are currently presented separately, while the success of this surgery depends on a combination of good cancer control with maintenance of continence and erections. We propose a score to jointly evaluate and report cancer control and functional results.

METHODS

The results of 205 radical prostatectomies were studied at one year. Cancer control was evaluated by PSA and continence and sexual potency were evaluated by a self-administered questionnaire. Each patient was attributed 0 or 4 points according to the presence or absence of biochemical progression (PSA > 0.2 ng/ml), 0 or 2 points according to the presence or absence of urinary incontinence (use of pads) and 0 or 1 point according to the presence or absence of impotence (no erections). The sum of these points provided a socre classifying the patient into 8 distinct categories, from 0 to 7, each corresponding to a specific status (from 0 (0 + 0 + 0): no cancer control-incontinence-impotence to 7 (4 + 2 + 1): cancer control-continence-sexual potency).

RESULTS

One year after the operation, 175 (85%) of patients had a PSA less than 0.2 ng/ml, 135 (65.8%) were continent and 64 (32.7%) reported erections. All patients with a score > or = 4 had good cancer control, wit no functional disorders for a score of 7 (4 + 2 + 1) (92%), no disorders of continence for a score of 6 (4 + 2 + 1) (31.5%), no disorders of erection for a score of 5 (4 + 0 + 1) (8.3%), or with incontinence and impotence for a score of 4 (4 + 0 + 0) (21.9%). All patients with a score < 4 had a PSA > 0.2 ng/ml, but with no functional disorders for a score for 3 (0 + 2 + 1) (2.4%), no incontinence for a score of 2 (0 + 2 + 0) (8.3%), and no impotence for a score of 1 (0 + 0 + 1) (1.9%). 1.9% of patients were incontinent, impotent and showed signs of biochemical progression (socre 0 = 0 + 0 + 0).

CONCLUSION

This score allows analysis of the global (cancer control and functional) results of radical prostatectomy and would facilitate comparisons between various surgical techniques (type of approach, nerve-sparing techniques) and various centres.

摘要

引言

根治性前列腺切除术的结果（癌症控制、控尿和性功能）目前是分别呈现的，而该手术的成功取决于良好的癌症控制与控尿和勃起功能维持的综合情况。我们提出一个评分系统来联合评估和报告癌症控制情况及功能结果。

方法

对205例根治性前列腺切除术患者术后一年的结果进行研究。通过前列腺特异性抗原（PSA）评估癌症控制情况，通过自我填写问卷评估控尿和性功能。根据是否存在生化进展（PSA>0.2 ng/ml），每位患者得0分或4分；根据是否存在尿失禁（使用尿垫），得0分或2分；根据是否存在阳痿（无法勃起），得0分或1分。这些分数的总和得出一个评分，将患者分为8个不同类别，从0到7分，每一类对应一种特定状态（从0分（0+0+0）：癌症未控制-尿失禁-阳痿到7分（4+2+1）：癌症控制-控尿-性功能正常）。

结果

术后一年，175例（85%）患者的PSA低于0.2 ng/ml，135例（65.8%）患者控尿正常，64例（32.7%）患者有勃起功能。所有评分≥4分的患者癌症控制良好，评分为7分（4+2+1）的患者无功能障碍（92%），评分为6分（4+2+0）的患者无控尿障碍（31.5%），评分为5分（4+0+1）的患者无勃起功能障碍（8.3%），评分为4分（4+0+0）的患者有尿失禁和阳痿（21.9%）。所有评分<4分的患者PSA>0.2 ng/ml，但评分为3分（0+2+1）的患者无功能障碍（2.4%），评分为2分（0+2+0）的患者无尿失禁（8.3%），评分为1分（0+0+1）的患者无阳痿（1.9%）。1.9%的患者有尿失禁、阳痿且有生化进展迹象（评分为0=0+0+0）。