Muñoz D, Vicens A, García-Montes F
Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España.
Actas Urol Esp. 2011 May;35(5):277-81. doi: 10.1016/j.acuro.2011.01.003. Epub 2011 Mar 9.
To know the incidence of vesicourethral anastomotic stricture in patients with prostate cancer treated with radical prostatectomy. Our secondary aim was to verify if postoperative radiotherapy increases the risk of presenting anastomotic stricture.
We retrospectively checked the clinical records of patients that had undergone radical prostatectomy as their primary treatment between January 2000 and December 2008, with a minimum clinical follow-up of 12 months. Of the total patients, 258 met the foregoing requirements. Of them, 25 (9.6%) received postoperative radiotherapy, 12 (48%) received adjuvant radiotherapy and 13 (52%) received salvage radiotherapy. The mean age of the patients that received radiotherapy was 64 (46-77) years. The mean pre-radiotherapy PSA was 2.3 (0.04-26.1) ng/ ml. The mean time between surgery and radiotherapy was 17.4 (3-72) months. The mean dosage administered was 68 (58-70) Gy. The mean follow-up was 50.5 (15-177) months.
Of 25 prostatectomized patients that received radiotherapy, four (16%) developed vesicourethral anastomotic stricture. The mean time from the completion of the radiotherapy until the appearance of the stricture was 4 months (1-22). On the other hand, 36 (15.4%) of the prostatectomized patients that did not receive postoperative radiotherapy presented the same complication. Comparatively, we did not note significant differences between both groups (p=0.599).
In our retrospective review, postoperative radiotherapy did not significantly increase the incidence of vesicourethral anastomotic stricture.
了解接受根治性前列腺切除术的前列腺癌患者膀胱尿道吻合口狭窄的发生率。我们的次要目的是验证术后放疗是否会增加出现吻合口狭窄的风险。
我们回顾性检查了2000年1月至2008年12月期间接受根治性前列腺切除术作为主要治疗方法且临床随访至少12个月的患者的临床记录。在所有患者中，258例符合上述要求。其中，25例（9.6%）接受了术后放疗，12例（48%）接受了辅助放疗，13例（52%）接受了挽救性放疗。接受放疗患者的平均年龄为64岁（46 - 77岁）。放疗前平均前列腺特异性抗原（PSA）为2.3 ng/ml（0.04 - 26.1）。手术与放疗之间的平均时间为17.4个月（3 - 72个月）。平均给予的剂量为68 Gy（58 - 70 Gy）。平均随访时间为50.5个月（15 - 177个月）。
在25例接受放疗的前列腺切除患者中，4例（16%）出现膀胱尿道吻合口狭窄。从放疗结束到出现狭窄的平均时间为4个月（1 - 22个月）。另一方面，未接受术后放疗的前列腺切除患者中有36例（15.4%）出现了相同的并发症。相比之下，我们未发现两组之间有显著差异（p = 0.599）。
在我们的回顾性研究中，术后放疗并未显著增加膀胱尿道吻合口狭窄的发生率。
