Viriyasiripong Sarayuth, Akarasakul Danaiphand, Thaidamrong Tanate, Doungkae Somjith
Division of Urology, Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2013 May;96(5):569-74.
To determine the predicting factor of biochemical recurrence and analysis of pathological and oncological outcomes following laparoscopic radical prostatectomy (LRP) at Rajavithi Hospital in Thailand.
One hundred twenty men underwent laparoscopic radical prostatectomy between October 2006 and December 2011. Four men were excluded due to open surgical conversions and fourteen men were excluded due to lacking of follow-up. The remaining 102 men had a mean preoperative prostate specific antigen of 21.4 ng/ml (ranging from 0.4 to 185) and Gleason score of 6.2 (ranging from 6 to 10). Stage was cT1b in one case (1%), cT1c in 66 (64.7%), cT2 in 28 (27. 5%), and cT3 in seven (6.9%). Immediate postoperative adjuvant therapy of twenty-six men was excluded from biochemical recurrence analysis.
Mean follow-up period was 19.7 months (median 16, ranging from 2 to 54.8). Pathological stage was pT0N0 in two men (2%), pT2N0 in 78 (76.5%), pT3N0 in 11 (10.8%), and pT2-3N1 in 11 (10.8%). Positive surgical margin (SM) rates increased with higher stage (23.1% in pT2, 63.6% in pT3 and 81.8% in pT2-3N1, p < 0.0001). Three-year biochemical recurrence-free survival was 87.1% for pT2N0 and 50% for pT3N0/N1 disease (p = 0.025), and 84.2% overall. Univariate analysis for age, preoperative PSA, postoperative Gleason score, pathological stage, and margin status showed that only margin status could be used as a predictor for biochemical recurrence.
Predicting factor for biochemical recurrence after LRP was positive SM status. From the oncological result, LRP in our experience is a safe and efficacious therapy for localized prostate cancer with acceptable and was consistent with results of previous studies.
确定泰国拉贾维蒂医院腹腔镜根治性前列腺切除术（LRP）后生化复发的预测因素，并分析病理及肿瘤学结局。
2006年10月至2011年12月期间，120名男性接受了腹腔镜根治性前列腺切除术。4名因转为开放手术被排除，14名因缺乏随访被排除。其余102名男性术前前列腺特异性抗原平均为21.4 ng/ml（范围0.4至185），Gleason评分6.2（范围6至10）。分期为cT1b 1例（1%），cT1c 66例（64.7%），cT2 28例（27.5%），cT3 7例（6.9%）。26名接受术后即刻辅助治疗的男性被排除在生化复发分析之外。
平均随访期为19.7个月（中位数16，范围2至54.8）。病理分期为pT0N0 2例（2%），pT2N0 78例（76.5%），pT3N0 11例（10.8%），pT2 - 3N1 11例（10.8%）。手术切缘阳性（SM）率随分期升高而增加（pT2中为23.1%，pT3中为63.6%，pT2 - 3N1中为81.8%，p < .0001）。pT2N0疾病的3年无生化复发生存率为87.1%，pT3N0/N1疾病为50%（p = 0.025），总体为84.2%。对年龄、术前PSA、术后Gleason评分、病理分期和切缘状态进行单因素分析显示，只有切缘状态可作为生化复发的预测因素。
LRP术后生化复发的预测因素是SM阳性状态。从肿瘤学结果来看，根据我们的经验，LRP对于局限性前列腺癌是一种安全有效的治疗方法，结果可接受且与先前研究一致。
