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接受耻骨后前列腺切除术的患者,其淋巴结数量与疾病参数之间是否存在关联?

Is there a relationship between the number of lymph nodes and disease parameters in patients who underwent retropubic prostatectomy.

作者信息

Demir Aslan, Karadağ Mert Ali, Türkeri Levent

机构信息

Department of Urology, Kafkas University Faculty of Medicine, Kars, Turkey,

出版信息

Int Urol Nephrol. 2014 Aug;46(8):1537-41. doi: 10.1007/s11255-014-0692-3. Epub 2014 Mar 25.

Abstract

PURPOSE

We aimed to establish the relationship between lymph nodes (LNs) counts that were removed with standard pelvic lymph node dissection (sPLND) and different disease parameters in patients who underwent radical prostatectomy (RP).

MATERIALS AND METHODS

A total of 70 patients who underwent sPLND during RP were scanned retrospectively. The scanned parameters were levels of serum PSA, the total weight of the removed prostate, the amount as a percentage of the tumor in the prostate tissue, the stage of the tumor, the total Gleason score (GS) and the number of standard pelvic lymph nodes that were removed from both right and left sides.

RESULTS

The average age of the patients was 59 years. A positive correlation was found between the total GS and the number of lymph nodes; while this correlation was significant (p = 0.0038), there was no significant difference between lymph nodes counts and other scanned parameters. The average pelvic lymph node numbers of patients with GS of 6-7 and 8 were 10.4-11.5 and 13.2, respectively. Lymph nodes metastases were found in 3 (4.2 %) patients whose average pelvic lymph node number was 17.3.

CONCLUSION

The chance of cure or decreased recurrence is much more possible in patients who had received extended PLND or at least standard one, because of the removal of much more lymph node tissues that have a high probability of disseminating cancer cells. This position can especially be considered in patients with high GS.

摘要

目的

我们旨在确定接受根治性前列腺切除术(RP)的患者中,标准盆腔淋巴结清扫术(sPLND)切除的淋巴结(LN)数量与不同疾病参数之间的关系。

材料与方法

回顾性扫描了70例在RP期间接受sPLND的患者。扫描参数包括血清PSA水平、切除前列腺的总重量、前列腺组织中肿瘤的占比、肿瘤分期、总 Gleason评分(GS)以及左右两侧切除的标准盆腔淋巴结数量。

结果

患者的平均年龄为59岁。总GS与淋巴结数量之间存在正相关;虽然这种相关性显著(p = 0.0038),但淋巴结数量与其他扫描参数之间无显著差异。GS为6 - 7和8的患者的平均盆腔淋巴结数量分别为10.4 - 11.5和13.2。在平均盆腔淋巴结数量为17.3的3例(4.2%)患者中发现了淋巴结转移。

结论

由于切除了更多极有可能播散癌细胞的淋巴结组织,接受扩大盆腔淋巴结清扫术或至少标准盆腔淋巴结清扫术的患者治愈或降低复发的可能性更大。对于GS高的患者尤其应考虑这一点。

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