Department of Urology, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, South Korea.
Department of Urology, College of Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju, South Korea.
Minerva Urol Nefrol. 2020 Oct;72(5):605-614. doi: 10.23736/S0393-2249.20.03633-4. Epub 2020 Apr 16.
This study was conducted to evaluate predictive factors of urinary continence recovery after radical prostatectomy (RP) for high-grade prostate cancer (PCa).
A total of 241 patients with high-grade (Gleason Score 8 or 9) PCa who underwent RP in a single Korean center between January 2011 and May 2018 were retrospectively reviewed. Urinary continence was defined as no pads use. Urinary continence was evaluated at 1, 3, 6, and 12 months after RP. Univariate and multivariate analyses were performed to determine the predictive factors of urinary continence recovery after RP.
The mean age was 67.6±6.4 years, and the mean PSA was 18.7±21.1 ng/dL. A total of 197 (81.7%) patients underwent nerve-sparing RP, and 198 patients (82.2%) were continent 1 year after RP. Multivariate analysis showed that the age (odds ratio [OR]=1.091 [1.015-1.172], P=0.018), Body Mass Index (BMI) (OR=1.227 [1.057-1.424], P=0.007), and modified surgical technique (OR=0.109 [0.044-0.267], P<0.001) were independent factors for predicting urinary continence recovery after RP.
Younger age, low BMI, and modified surgery were independent predictors of urinary continence recovery after RP in patients with high-grade PCa. These findings may help surgeons to give pre- and postoperative advice to patients with high-grade PCa about urinary continence recovery after RP.
本研究旨在评估行根治性前列腺切除术（RP）治疗高级别前列腺癌（PCa）后尿控恢复的预测因素。
回顾性分析 2011 年 1 月至 2018 年 5 月期间在韩国的单一中心接受 RP 治疗的 241 例高级别（Gleason 评分 8 或 9）PCa 患者。尿控定义为不使用尿垫。术后 1、3、6 和 12 个月评估尿控。进行单因素和多因素分析以确定 RP 后尿控恢复的预测因素。
患者的平均年龄为 67.6±6.4 岁，平均 PSA 为 18.7±21.1ng/dL。197 例（81.7%）患者接受了神经保留 RP，198 例（82.2%）患者在 RP 后 1 年时达到尿控。多因素分析显示，年龄（优势比[OR]=1.091[1.015-1.172]，P=0.018）、体重指数（BMI）（OR=1.227[1.057-1.424]，P=0.007）和改良手术技术（OR=0.109[0.044-0.267]，P<0.001）是预测 RP 后尿控恢复的独立因素。
在高级别 PCa 患者中，年轻、低 BMI 和改良手术是 RP 后尿控恢复的独立预测因素。这些发现可能有助于外科医生向高级别 PCa 患者提供关于 RP 后尿控恢复的术前和术后建议。
