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[前列腺癌手术的肿瘤学结局]

[Oncological outcomes of prostate cancer surgery].

作者信息

Soulié M, Salomon L

机构信息

Département d'urologie-andrologie-transplantation rénale, CHU Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France.

Service d'urologie et de transplantation rénale et pancréatique, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.

出版信息

Prog Urol. 2015 Nov;25(15):1010-27. doi: 10.1016/j.purol.2015.07.015.

Abstract

OBJECTIVE

Review of the oncological results of the radical prostatectomy as initial treatment of prostate cancer, according to the surgical approach and the risk stratification using D'Amico risk groups.

MATERIALS AND METHODS

Review of literature using Medline databases and MedScience based on scientific relevance. Research focused on the oncological results of the radical prostatectomy in series and meta-analysis published since 10 years, taking into consideration the surgical approach if mentioned.

RESULTS

The characteristics of the operated tumor highly impact the local control authenticated by the pathologic stage and the rates of positive surgical margins (PSM), in addition to the survival and the biochemical recurrence. Surgical technique adapted according to the tumor treated, was a constant challenge to the urologist, who counter balance between the oncological control and the conservation of urinary and sexual function by conditioning the type of radical prostatectomy. Results of radical prostatectomy acceptable in terms of PSM and survival are not influenced by the surgical approach but by the degree of surgical experience.

CONCLUSION

Results of radical prostatectomy show the efficient local control of prostate cancer, taking into consideration the oncological rules and indications validated by multidisciplinary meetings, based on the national (CCAFU) and European oncological guidelines. Tendency is going toward considering radical prostatectomy indicated for patients with higher risk of disease progression, so integrating surgery in a multidisciplinary personalized approach.

摘要

目的

根据手术方式以及使用达米科风险分组进行的风险分层,回顾根治性前列腺切除术作为前列腺癌初始治疗的肿瘤学结果。

材料与方法

基于科学相关性,使用Medline数据库和医学科学网对文献进行回顾。研究聚焦于近十年来发表的系列研究和荟萃分析中根治性前列腺切除术的肿瘤学结果,若有提及则考虑手术方式。

结果

除生存和生化复发外,手术切除肿瘤的特征对由病理分期和手术切缘阳性率(PSM)所证实的局部控制有高度影响。根据所治疗的肿瘤调整手术技术,始终是泌尿外科医生面临的挑战,他们通过确定根治性前列腺切除术的类型,在肿瘤学控制与保留泌尿和性功能之间取得平衡。就PSM和生存而言,根治性前列腺切除术的结果不受手术方式影响,而是受手术经验程度的影响。

结论

根治性前列腺切除术的结果显示出对前列腺癌有效的局部控制,这是基于国家(CCAFU)和欧洲肿瘤学指南,考虑到多学科会议验证的肿瘤学规则和适应症。趋势是倾向于将根治性前列腺切除术用于疾病进展风险较高的患者,从而将手术纳入多学科个性化治疗方案中。

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