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根治性前列腺切除术后切缘阳性对生化失败、无生化复发生存率及总生存率的影响:长期中位结果

Effect of positive surgical margins on biochemical failure, biochemical recurrence-free survival, and overall survival after radical prostatectomy: median long-term results.

作者信息

Huri Emre, Aydogmus Yasin, Doluoglu Omer Gokhan, Dadali Mumtaz, Karakan Tolga, Emir Levent, Germiyanoglu Cankon

机构信息

Department of Urology, Clinic of Ankara Training and Research Hospital, Ankara, Turkey.

Department of Urology, Clinic of Dr Sami Ulus Maternity, Children Health and Diseases Training and Research Hospital, Ankara, Turkey.

出版信息

Kaohsiung J Med Sci. 2014 Oct;30(10):510-4. doi: 10.1016/j.kjms.2014.04.001. Epub 2014 May 23.

Abstract

The aim of this study was to investigate the median long-term effects of positive surgical margin (PSM) and other prognostic factors on biochemical recurrence-free survival, overall survival, and biochemical failure in patients who underwent radical prostatectomy. Our study included 121 patients with pT2-3N0 disease treated between March 2006 and August 2012. The patients were divided into two groups: those with PSM and those with negative surgical margin (NSM). We analyzed the age, clinical and pathological stages, preoperative and postoperative Gleason scores, duration of the follow-up, adjuvant chemo-/radiotherapy, biochemical failure, biochemical recurrence-free survival, and overall survival in these patients. PSM was found in 25 (20%) patients, whereas 96 patients had NSM. The median follow-up time was 46.6 months (range 12-72 months) for the PSM group and 48.3 months (range 7-149 months) for the NSM group. The biochemical failure rate was 24% in the PSM group and 8.3% in the NSM group (p = 0.029). The biochemical recurrence-free survival was found as 76% in the PSM group and 91.7% in the NSM group. The difference between the groups was not statistically significant (p = 0.06). The overall survival was 100% in both groups. The surgical margins of the radical prostatectomy material is an important pathological indicator for biochemical failure at mid long-term follow-up. We did not find any effect of PSM on overall survival or biochemical recurrence-free survival.

摘要

本研究旨在探讨阳性手术切缘(PSM)及其他预后因素对接受根治性前列腺切除术患者生化无复发生存率、总生存率和生化失败的中期长期影响。我们的研究纳入了2006年3月至2012年8月期间接受治疗的121例pT2-3N0疾病患者。患者分为两组:PSM组和阴性手术切缘(NSM)组。我们分析了这些患者的年龄、临床和病理分期、术前和术后Gleason评分、随访时间、辅助化疗/放疗、生化失败、生化无复发生存率和总生存率。25例(20%)患者发现有PSM,而96例患者有NSM。PSM组的中位随访时间为46.6个月(范围12 - 72个月),NSM组为48.3个月(范围7 - 149个月)。PSM组的生化失败率为24%,NSM组为8.3%(p = 0.029)。PSM组的生化无复发生存率为76%,NSM组为91.7%。两组之间的差异无统计学意义(p = 0.06)。两组的总生存率均为100%。根治性前列腺切除标本的手术切缘是中长期随访中生化失败的重要病理指标。我们未发现PSM对总生存率或生化无复发生存率有任何影响。

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Impact of surgical margin status on prostate-cancer-specific mortality.手术切缘状态对前列腺癌特异性死亡率的影响。
BJU Int. 2012 Dec;110(11):1684-9. doi: 10.1111/j.1464-410X.2012.11371.x. Epub 2012 Jul 12.

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