Department of Urology, RWTH University Aachen, Aachen, Germany.
Panminerva Med. 2010 Sep;52(3):231-8.
Radical salvage prostatectomy represents a secondary local treatment with curative intent in patients with organ confined PCA recurrences following radiation therapy. Preoperative risk factors predicting organ confined disease are initial LDR brachytherapy, preoperative Gleason biopsy score ≤6, ≤50% biopsy cores involved with cancer, and a 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 is evaluated by urethrocystosocopy and urodynamics. Most appropriate candidates for radical salvage prostatectomy are patients with organ confined disease or those with symptomatic local recurrences. In experienced hands, morbidity is low with a continence rate of 83-96% depending on the type of previous radiation therapy. Long-term oncological control can be achieved in more than 80% of the patients.
根治性前列腺切除术是一种有治愈意图的二线局部治疗方法，适用于接受放射治疗后发生器官局限性前列腺癌复发的患者。预测器官局限性疾病的术前危险因素包括：初始低剂量率近距离放射治疗、术前 Gleason 活检评分≤6、≤50%的活检核心受累于癌症，以及 PSA 倍增时间>12 个月。术前应通过骨闪烁扫描、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。下尿路功能通过尿道膀胱镜检查和尿动力学评估。最适合接受根治性前列腺切除术的患者是那些患有器官局限性疾病或有症状的局部复发的患者。在有经验的医生手中，发病率较低，根据先前放射治疗的类型，有 83-96%的患者保持尿控。超过 80%的患者可以实现长期的肿瘤学控制。
