Department of Urology, Daiyukai Daiichi Hospital, Ichinomiya 4918551, Japan.
Department of Urology, Graduate School of Medicine, Gifu University, Gifu 5011194, Japan.
Curr Oncol. 2022 Apr 18;29(4):2864-2870. doi: 10.3390/curroncol29040233.
Recently, cytoreductive prostatectomy for metastatic prostate cancer (mPCa) has been associated with improved oncological outcomes. This study was aimed at evaluating whether robot-assisted radical prostatectomy (RARP) as a form of cytoreductive prostatectomy can improve oncological outcomes in patients with mPCa. We conducted a retrospective study of twelve patients with mPCa who had undergone neoadjuvant therapy followed by RARP. The endpoints were biochemical recurrence-free survival, treatment-free survival, and de novo metastasis-free survival. At the end of the follow-up period, none of the enrolled patients had died from PCa. The 1- and 2-year biochemical recurrence-free survival rates were 83.3% and 66.7%, respectively, and treatment-free survival rates were 75.0% and 56.3%, respectively. One patient developed de novo bone metastases 6.4 months postoperatively, and castration-resistant prostate cancer 8.9 months postoperatively. After RARP, the median duration of recovery of urinary continence was 5.2 months. One patient had severe incontinence (>2 pads/day) 24 months postoperatively. RARP may be a treatment option in patients with mPCa who have achieved a serum prostate-specific antigen level < 0.2 ng/mL, and present without new lesions on imaging.
最近，转移性前列腺癌（mPCa）的细胞减灭性前列腺切除术与改善肿瘤学结果相关。本研究旨在评估作为细胞减灭性前列腺切除术的一种形式的机器人辅助根治性前列腺切除术（RARP）是否可以改善 mPCa 患者的肿瘤学结果。我们对 12 例接受新辅助治疗后行 RARP 的 mPCa 患者进行了回顾性研究。终点是生化无复发生存、无治疗生存和新发转移无复发生存。在随访期末，所有入组患者均未死于前列腺癌。1 年和 2 年的生化无复发生存率分别为 83.3%和 66.7%，无治疗生存率分别为 75.0%和 56.3%。1 例患者术后 6.4 个月发生新发骨转移，术后 8.9 个月发生去势抵抗性前列腺癌。行 RARP 后，尿控恢复的中位时间为 5.2 个月。1 例患者术后 24 个月出现严重尿失禁（>2 片/天）。对于血清前列腺特异性抗原水平<0.2ng/mL 且影像学无新发病变的 mPCa 患者，RARP 可能是一种治疗选择。
