Heidenreich A, Thüer D, Pfister D
Klinik für Urologie, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Urologe A. 2010 Jun;49(6):734-40. doi: 10.1007/s00120-009-2064-7.
Radical salvage prostatectomy represents a secondary local treatment with curative intent in patients with organ-confined prostate cancer (PC) recurrences following radiation therapy. Preoperative risk factors predicting organ-confined disease are initial low dose rate (LDR) brachytherapy, preoperative Gleason biopsy score<or=6, <or=50% biopsy cores involved with cancer, and a prostate-specific antigen (PSA) doubling time>12 months. Metastatic disease should be ruled out preoperatively by skeletal scintigraphy, abdominal computed tomography or magnetic resonance imaging, and/or choline-PET/CT. Functionality of the lower urinary tract needs to be preoperatively evaluated by urethrocystoscopy and urodynamics. With appropriate patient selection, oncological control can be achieved in 80% of patients. A continence rate of 83%-96% depending on the type of previous radiation therapy is achievable.
根治性挽救性前列腺切除术是对放疗后出现器官局限性前列腺癌（PC）复发患者进行的一种具有治愈意图的二次局部治疗。预测器官局限性疾病的术前危险因素包括初始低剂量率（LDR）近距离放疗、术前Gleason活检评分≤6、≤50%的活检核心有癌累及以及前列腺特异性抗原（PSA）倍增时间＞12个月。术前应通过骨骼闪烁显像、腹部计算机断层扫描或磁共振成像和/或胆碱-PET/CT排除转移性疾病。术前需要通过尿道膀胱镜检查和尿动力学评估下尿路功能。通过适当的患者选择，80%的患者可实现肿瘤学控制。根据先前放疗的类型，控尿率可达83%-96%。
