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比较年龄≧75 岁的老年男性与年轻男性行机器人辅助根治性前列腺切除术的围手术期结局。

Comparison of perioperative outcomes in elderly (age ≧ 75 years) vs. younger men undergoing robot-assisted radical prostatectomy.

机构信息

Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Department of Urology, Jichi Medical University, Shimotsuke-shi, Tochigi-ken, Japan.

出版信息

PLoS One. 2020 Jun 4;15(6):e0234113. doi: 10.1371/journal.pone.0234113. eCollection 2020.

Abstract

OBJECTIVES

To investigate perioperative, oncologic, and functional outcomes of robot-assisted radical prostatectomy (RARP) in men of age ≥ 75 years in comparison with younger men.

METHODS

From November 2011 to December 2018, six hundred and thirty patients with prostate cancer underwent robot-assisted radical prostatectomy (RARP). A total of 614 patients were analyzed after excluding 16 patients who were treated with hormone therapy prior to RARP. Patients were divided into 2 groups based on their age (age ≥ 75 years: N = 46 patients and age < 75 years: N = 568 patients). Perioperative parameters regarding oncologic/functional outcomes and complication status were compared between the 2 groups. Clavien-Dindo classification was used to classify perioperative complications. Clinical and pathological status including stage, positive margin, continence, and potency status after RARP were analyzed.

RESULTS

Five-hundred sixty-eight and forty-six men were of age <75 and ≥ 75 years, respectively. There were no significant differences between the 2 groups in terms of oncologic outcomes (positive resection margin rate and PSA failure). The duration of hospitalization was longer in older patients but was not statistically significant (P = 0.051). A total number of Clavien ≥3 complications that occurred within a month after RARP were 15 (2.6%) and 2 (4.3%) in younger men (age < 75 years) and older men (age ≥ 75 years), respectively (P = 0.359).

CONCLUSION

The present study showed that the oncologic and surgical outcomes in the elderly group were similar to those in the younger population. However, the duration of hospitalization seemed to be longer in older patients (age ≥ 75 years), despite similar complication rates.

摘要

目的

比较≥75 岁和<75 岁男性机器人辅助根治性前列腺切除术(RARP)的围手术期、肿瘤学和功能结果。

方法

2011 年 11 月至 2018 年 12 月,630 例前列腺癌患者接受机器人辅助根治性前列腺切除术(RARP)。排除 RARP 前接受激素治疗的 16 例患者后,对 614 例患者进行了分析。根据年龄将患者分为两组(年龄≥75 岁:N=46 例;年龄<75 岁:N=568 例)。比较两组患者围手术期的肿瘤学/功能结果和并发症情况。采用 Clavien-Dindo 分级对围手术期并发症进行分类。分析 RARP 后的临床和病理状况,包括分期、阳性切缘、尿控和勃起功能状态。

结果

年龄<75 岁和≥75 岁的患者分别为 568 例和 46 例。两组患者在肿瘤学结果(阳性切缘率和 PSA 失败)方面无显著差异。老年患者的住院时间较长,但无统计学意义(P=0.051)。RARP 后 1 个月内发生的 Clavien≥3 级并发症分别为 15 例(2.6%)和 2 例(4.3%),年龄<75 岁的年轻患者和年龄≥75 岁的老年患者分别为 15 例(2.6%)和 2 例(4.3%)(P=0.359)。

结论

本研究表明,老年组的肿瘤学和手术结果与年轻人群相似。然而,尽管并发症发生率相似,但老年患者(年龄≥75 岁)的住院时间似乎更长。

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