Autorino R, Porpiglia F, Dasgupta P, Rassweiler J, Catto J W, Hampton L J, Lima E, Mirone V, Derweesh I H, Debruyne F M J
Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA.
Division of Urology, University of Turin, San Luigi Hospital, Orbassano, Italy.
Eur J Surg Oncol. 2017 May;43(5):893-908. doi: 10.1016/j.ejso.2017.02.005. Epub 2017 Feb 20.
The landscape of the surgical management of urologic malignancies has dramatically changed over the past 20 years. On one side, better diagnostic and prognostic tools allowed better patient selection and more reliable surgical planning. On the other hand, the implementation of minimally invasive techniques and technologies, such as robot-assisted laparoscopy surgery and image-guided surgery, allowed minimizing surgical morbidity. Ultimately, these advances have translated into a more tailored approach to the management of urologic cancer patients. Following the paradigm of "precision medicine", contemporary urologic surgery has entered a technology-driven era of "precision surgery", which entails a range of surgical procedures tailored to combine maximal treatment efficacy with minimal impact on patient function and health related quality of life. Aim of this non-systematic review is to provide a critical analysis of the most recent advances in the field of surgical uro-oncology, and to define the current and future role of "precision surgery" in the management of genitourinary cancers.
在过去20年里,泌尿生殖系统恶性肿瘤的外科治疗格局发生了巨大变化。一方面,更好的诊断和预后工具使患者选择更优,手术规划更可靠。另一方面,微创技术和科技的应用,如机器人辅助腹腔镜手术和图像引导手术,降低了手术并发症。最终,这些进展转化为对泌尿生殖系统癌症患者更具针对性的治疗方法。遵循“精准医学”的范式,当代泌尿外科手术已进入技术驱动的“精准手术”时代,这需要一系列手术程序,以在对患者功能和健康相关生活质量影响最小的情况下实现最大治疗效果。本非系统性综述的目的是对泌尿外科肿瘤学领域的最新进展进行批判性分析,并确定“精准手术”在泌尿生殖系统癌症管理中的当前和未来作用。