Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
Department of Oncologic Chemotherapy, Shandong Second Provincial General Hospital, Jinan, 250022, Shandong, China.
BMC Urol. 2022 Jul 28;22(1):118. doi: 10.1186/s12894-022-01068-7.
This is an exploratory research of cystoprostatectomy (CP) in treating prostate cancer (PCa) extending to the bladder, which aimed to evaluate the effects of CP on survival outcomes and improving quality of life (QoL) in these patients.
A total of 27 PCa patients extending to the bladder were subjected to CP and followed up at regular intervals in our center. Prostate cancer-specific survival (PCSS) and prostate-specific antigen recurrence-free survival (PFS) were assessed by Kaplan-Meier analysis. Multivariate Cox regression was performed to evaluate clinical characteristics predicting survivals. QoL and pelvic symptoms were also evaluated.
Median PCSS was not reached over the period of follow-up. 5-year PCSS rate was 82.1%. Median PFS was 66.0 months. 5-year PFS rate was 58.5%. Multivariate analysis showed Gleason score (≥ 8) (hazard ratio (HR) 2.55, 95% confidence interval (CI) 1.28-4.04, p = 0.033), positive local lymph node status (HR 3.52, 95% CI 1.57-7.38, p = 0.006) and bladder muscle-invasion (HR 4.75, 95% CI 1.37-7.53, p < 0.001) were independent predictors of worse PCSS. The number of patients suffering pelvic symptoms was significantly decreased, and QoL scores were significantly down-regulated after surgeries.
CP offered effective and durable palliation in patients of locally advanced prostate cancer with invasion of the bladder, providing better QoL and relieving local symptoms.
这是一项探索性研究，旨在评估膀胱前列腺切除术（CP）治疗前列腺癌（PCa）侵犯膀胱的效果，以评估 CP 对这些患者生存结果和生活质量（QoL）的影响。
我们中心对 27 例前列腺癌侵犯膀胱的患者进行 CP 治疗，并定期随访。通过 Kaplan-Meier 分析评估前列腺癌特异性生存（PCSS）和前列腺特异性抗原无复发生存（PFS）。采用多变量 Cox 回归分析评估预测生存的临床特征。还评估了 QoL 和盆腔症状。
中位随访期内未达到 PCSS。5 年 PCSS 率为 82.1%。中位 PFS 为 66.0 个月。5 年 PFS 率为 58.5%。多变量分析显示，Gleason 评分（≥8）（风险比（HR）2.55，95%置信区间（CI）1.28-4.04，p=0.033）、局部淋巴结阳性状态（HR 3.52，95%CI 1.57-7.38，p=0.006）和膀胱肌肉浸润（HR 4.75，95%CI 1.37-7.53，p<0.001）是 PCSS 较差的独立预测因素。手术后，患有盆腔症状的患者数量明显减少，QoL 评分明显降低。
CP 为局部晚期前列腺癌侵犯膀胱的患者提供了有效的、持久的缓解，改善了 QoL，缓解了局部症状。
