Kang Ho Won, Lee Joo Yong, Kwon Jong Kyou, Jeh Seong Uk, Jung Hae Do, Choi Young Deuk
Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. ; Robot and Minimal Invasive Surgery Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean J Urol. 2014 Oct;55(10):629-35. doi: 10.4111/kju.2014.55.10.629. Epub 2014 Oct 10.
Despite the wide application of prostate-specific antigen-based screening leading to a profound stage migration in prostate cancer (PC), a significant percentage of men are still being diagnosed with clinically high-risk disease that requires aggressive treatment. Optimal management in these patients remains challenging, and strong advocates for radical prostatectomy (RP), radiotherapy, androgen deprivation therapy, and, increasingly, a multimodal approach abound. Currently, surgery for high-risk PC is frequently applied. RP offers an attractive opportunity for tumor excision either as a definitive management or as a first step in multimodal therapy. Nevertheless, this approach is still controversial. In this review, we discuss the current evidence for the role of RP in this clinical setting, including surgical considerations and outcomes. The role of robot-assisted RP, which is increasingly utilized in Korea in this clinical scenario, is discussed.
尽管基于前列腺特异性抗原的筛查得到广泛应用，导致前列腺癌（PC）的分期出现显著变化，但仍有相当比例的男性被诊断为临床高危疾病，需要积极治疗。对这些患者进行最佳管理仍然具有挑战性，强烈主张根治性前列腺切除术（RP）、放射治疗、雄激素剥夺治疗的人众多，并且越来越多的人主张采用多模式治疗方法。目前，高危PC的手术治疗经常被采用。RP为肿瘤切除提供了一个有吸引力的机会，既可以作为确定性治疗，也可以作为多模式治疗的第一步。然而，这种方法仍然存在争议。在本综述中，我们讨论了RP在这种临床情况下作用的当前证据，包括手术注意事项和结果。还讨论了机器人辅助RP的作用，在韩国这种临床情况下，机器人辅助RP的使用越来越多。
