老年患者接受机器人辅助根治性前列腺切除术的手术耐受性与衰弱:一项叙述性综述
Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review.
作者信息
Yamada Yuta, Taguchi Satoru, Kume Haruki
机构信息
Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo 113-8655, Japan.
出版信息
Cancers (Basel). 2022 Oct 16;14(20):5061. doi: 10.3390/cancers14205061.
Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an indicator for choosing treatment options. However, determination of life expectancy can be complicated and difficult in some cases. In addition, surgical tolerability is also an important issue. Since frailty may be a major concern, it may be logical to use geriatric assessment tools to discriminate 'surgically fit' patients from unfit patients. Landmark studies show two valid models such as the phenotype model and the cumulative deficit model that allow for the diagnosis of frailty. Many studies have also developed geriatric screening tools such as VES-13 and G8. These tools may have the potential to directly sort out unfit patients for surgery preoperatively.
机器人辅助根治性前列腺切除术(RARP)现已成为局限性前列腺癌的金标准治疗方法。前列腺癌治疗的决策中有多个要素。其中一个重要要素是预期寿命,当前指南推荐将其作为选择治疗方案的指标。然而,在某些情况下,预期寿命的确定可能复杂且困难。此外,手术耐受性也是一个重要问题。由于虚弱可能是一个主要关注点,使用老年评估工具来区分“适合手术”和“不适合手术”的患者可能是合理的。具有里程碑意义的研究显示了两种有效的模型,如表型模型和累积缺陷模型,可用于诊断虚弱。许多研究还开发了老年筛查工具,如VES-13和G8。这些工具可能有潜力在术前直接筛选出不适合手术的患者。