Department of Urology, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Pathology, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2021 Feb;23(2):111-115.
Little is known about oncologic outcomes following robot-assisted-radical-prostatectomy (RALP) for clinical T3 (cT3) prostate cancer.
To investigate oncologic outcomes of patients with cT3 prostate cancer treated by RALP.
Medical records of patients who underwent RALP from 2010 to 2018 were retrieved. cT3 cases were reviewed. Demographic and pre/postoperative pathology data were analyzed. Patients were followed in 3-6 month intervals with repeat PSA analyses. Adjuvant/salvage treatments were monitored. Biochemical recurrence (BCR) meant PSA levels of ≥ 0.2 ng/ml.
Seventy-nine patients met inclusion criteria. Median age at surgery was 64 years. Preoperative PSA level was 7.14 ng/dl, median prostate weight was 54 grams, and 23 cases (29.1%) were down-staged to pathological stage T2. Positive surgical margin rate was 42%. Five patients were lost to follow-up. Median follow-up time for the remaining 74 patients was 24 months. Postoperative relapse in PSA levels occurred in 31 patients (42%), and BCR in 28 (38%). Median time to BCR was 9 months. The overall 5-year BCR-free survival rate was 61%. Predicting factors for BCR were age (hazard-ratio [HR] 0.85, 95% confidence interval [95%CI] 0.74-0.97, P = 0.017) and prostate weight (HR 1.04, 95%CI 1.01-1.08, P = 0.021). Twenty-six patients (35%) received adjuvant/salvage treatments. Three patients died from metastatic prostate cancer 31, 52, and 78 months post-surgery. Another patient died 6 months post-surgery of unknown reasons. The 5-year cancer-specific survival rate was 92.
RALP is an oncologic effective procedure for cT3 prostate cancer. Adjuvant/salvage treatment is needed to achieve optimal disease-control.
机器人辅助根治性前列腺切除术（RALP）治疗临床 T3（cT3）前列腺癌的肿瘤学结果知之甚少。
研究 RALP 治疗 cT3 前列腺癌患者的肿瘤学结果。
回顾性分析 2010 年至 2018 年接受 RALP 治疗的患者的病历。回顾 cT3 病例。分析人口统计学和术前/术后病理数据。患者每隔 3-6 个月进行一次 PSA 分析随访。监测辅助/挽救治疗。生化复发（BCR）是指 PSA 水平≥0.2ng/ml。
79 名患者符合纳入标准。手术时的中位年龄为 64 岁。术前 PSA 水平为 7.14ng/dl，中位前列腺重量为 54 克，23 例（29.1%）降期至病理 T2 期。切缘阳性率为 42%。5 例患者失访。其余 74 例患者的中位随访时间为 24 个月。31 例（42%）患者术后 PSA 水平复发，28 例（38%）发生 BCR。BCR 的中位时间为 9 个月。总体 5 年 BCR 无复发生存率为 61%。BCR 的预测因素是年龄（风险比[HR]0.85，95%置信区间[95%CI]0.74-0.97，P=0.017）和前列腺重量（HR 1.04，95%CI 1.01-1.08，P=0.021）。26 例（35%）患者接受了辅助/挽救治疗。3 例患者分别在术后 31、52 和 78 个月死于转移性前列腺癌。另一名患者术后 6 个月死于不明原因。5 年癌症特异性生存率为 92%。
RALP 是治疗 cT3 前列腺癌的一种有效的肿瘤学方法。需要辅助/挽救治疗以达到最佳疾病控制。
