Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, 467-8601 Nagoya, Japan.
BMC Urol. 2012 Dec 18;12:36. doi: 10.1186/1471-2490-12-36.
Few reports can be found in the literature with respect to the impact of neoadjuvant hormonal therapy (NHT) on operative parameters on laparoscopic radical prostatectomy (LRP) in a large study. The aim of this study was to evaluate the safety and efficacy of NHT prior to LRP for locally confined prostate cancer.
From January 2004 to September 2009, 342 patients undergoing LRP were analyzed, specifically comparing 72 patients who received NHT to 270 who did not. All patients were in clinical stage T2 and nerve sparing LRP were not included.
The mean patient age, preoperative prostate specific antigen (PSA), clinical stage, and biopsy Gleason grade were similar for the NHT and the non-NHT LRP groups. The median blood loss and the median operative time were also similar. There were no differences in the intraoperative complication rate of rectum injury, blood transfusion, and open surgery conversion. The positive surgical margin rate was significantly improved in NHT patients. Moreover, PSA recurrence within two years was significantly less in long-term NHT than in non-NHT patients.
LRP was shown as a safe and efficacious procedure in patients who have received NHT. Perioperative morbidity of NHT patients undergoing LRP appears equivalent to non-NHT patients, with lower positive surgical margin, and PSA recurrence rate.
在大型研究中，很少有文献报道新辅助激素治疗（NHT）对腹腔镜根治性前列腺切除术（LRP）手术参数的影响。本研究旨在评估 NHT 对局限性前列腺癌行 LRP 的安全性和有效性。
2004 年 1 月至 2009 年 9 月，分析了 342 例行 LRP 的患者，具体比较了 72 例接受 NHT 的患者和 270 例未接受 NHT 的患者。所有患者均处于临床 T2 期，不包括保留神经的 LRP。
NHT 和非 NHT LRP 组患者的平均年龄、术前前列腺特异性抗原（PSA）、临床分期和活检 Gleason 分级相似。中位出血量和中位手术时间也相似。直肠损伤、输血和开放性手术转换的术中并发症发生率无差异。NHT 患者的阳性切缘率显著改善。此外，长期 NHT 患者的 PSA 复发率明显低于非 NHT 患者。
LRP 是一种安全有效的治疗方法，适用于接受 NHT 的患者。接受 NHT 的 LRP 患者的围手术期发病率与非 NHT 患者相当，阳性切缘率和 PSA 复发率较低。
