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前列腺癌根治术和盆腔淋巴结清扫术后淋巴结转移患者的长期预后

[Long-term outcomes of prostate cancer patients with lymph nodes metastasis after radical prostatectomy and pelvic lymph node dissection].

作者信息

De Vergie S, Gaschignard N, Baron M, Branchereau J, Luyckx F, Butel T, Perrouin-Verbe M-A, Bouchot O, Rigaud J

机构信息

Service d'urologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.

Service d'urologie, centre hospitalier de la Roche/Yon, 85000 La Roche/Yon, France.

出版信息

Prog Urol. 2018 Jan;28(1):25-31. doi: 10.1016/j.purol.2017.10.003. Epub 2017 Dec 6.

Abstract

INTRODUCTION

The aim of this study was to evaluate biochemical recurrence-free survival (RFS) and to identify useful predictors of such survival in localized prostate cancer patients (cN0) and pelvic lymph node metastasis (pN+) treated with radical prostatectomy and pelvic lymph node dissection.

PATIENTS AND METHODS

This multicenter and retrospective study, assessed overall survival (OS), cancer specific survival (CSS) and biochemical recurrence-free survival (RFS), between January 2005 until December 2010 with 5 years of distance. We evaluated factors predicting long-term RFS in node positive prostate cancer patients.

RESULTS

Thus, 30 patients were included. Median follow-up was 89.9±27.4 months. After surgery, patients were treated with surveillance (n=4, 13.5%), adjuvant hormone therapy (n=22, 73%) or combination of radio and hormone therapy, (n=4, 13.5%). During the follow-up, 50% of patients had biochemical recurrence, with a mean time period of 38±30 months. Five and 10-year RFS were 57% and 41% respectively. Extra lymph nodes extension (P=0.00021) and pathological margin status (P=0.0065) were independent predictors of 5-year RFS.

CONCLUSION

Biochemical RFS of patients treated with radical prostatectomy and subclinical lymph node metastatic disease is adequate and multifactorial. However, this study identifies pathological margin status and extra lymph node extension as independent factors of b RFS.

LEVEL OF EVIDENCE

摘要

引言

本研究的目的是评估局限性前列腺癌患者(cN0)及接受根治性前列腺切除术和盆腔淋巴结清扫术的盆腔淋巴结转移患者(pN+)的无生化复发生存率(RFS),并确定此类生存的有用预测指标。

患者与方法

这项多中心回顾性研究评估了2005年1月至2010年12月期间间隔5年的总生存期(OS)、癌症特异性生存期(CSS)和无生化复发生存期(RFS)。我们评估了预测淋巴结阳性前列腺癌患者长期RFS的因素。

结果

共纳入30例患者。中位随访时间为89.9±27.4个月。术后,患者接受观察(n = 4,13.5%)、辅助激素治疗(n = 22,73%)或放疗与激素治疗联合(n = 4,13.5%)。随访期间,50%的患者出现生化复发,平均时间为38±30个月。5年和10年RFS分别为57%和41%。淋巴结外扩展(P = 0.00021)和病理切缘状态(P = 0.0065)是5年RFS的独立预测指标。

结论

接受根治性前列腺切除术和亚临床淋巴结转移疾病治疗患者的生化RFS是足够的且受多因素影响。然而,本研究确定病理切缘状态和淋巴结外扩展是生化RFS的独立因素。

证据水平

4级。

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