机器人辅助挽救性根治性前列腺切除术的肿瘤学和功能学结果：报告首例 10 例。
Oncologic and Functional Outcomes of Salvage Robot-Assisted Radical Prostatectomy: Report of the First 10 Cases.
机构信息
Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
出版信息
Curr Oncol. 2024 Aug 20;31(8):4762-4768. doi: 10.3390/curroncol31080356.
BACKGROUND
Salvage robot-assisted radical prostatectomy (sRARP) after PSA failure in patients who underwent initial radiotherapy or focal therapy has rarely been reported in Japan. We aimed to report the oncologic and functional outcomes of the first 10 cases of sRARP.
METHODS
Ten patients underwent sRARP after failing to respond to initial radiotherapy or focal therapy. Initial definitive treatment included volumetric modulated arc therapy, intensity-modulated radio therapy, stereotactic body radiotherapy, heavy-ion radiotherapy, low-dose-rate brachytherapy, and high-intensity focused ultrasound. We retrospectively investigated 10 cases on oncologic and functional outcomes of sRARP.
RESULTS
The median PSA level at sRARP, amount of blood loss, and console time were 2.17 ng/mL, 100 mL, and 136 min, respectively. Positive surgical margins were found in half of the cases. Median follow-up was 1.1 years. There were no 30-day major complications. No patients had erections after sRARP. Urinary continence and biochemical recurrence (BCR) rate were 40% and 30% at 1 year after sRARP, respectively.
CONCLUSIONS
Salvage RARP may be a feasible option after PSA failure in patients who underwent radiotherapy or focal therapy as initial treatment, showing acceptable BCR rate.
背景
在初始放疗或局部治疗后 PSA 失败的患者中进行挽救性机器人辅助根治性前列腺切除术（sRARP）在日本鲜有报道。我们旨在报告首例 10 例 sRARP 的肿瘤学和功能结果。
方法
10 例患者在初始放疗或局部治疗失败后接受 sRARP。初始确定性治疗包括容积调强弧形治疗、强度调制放疗、立体定向体部放疗、重离子放疗、低剂量率近距离放疗和高强度聚焦超声。我们回顾性调查了 10 例 sRARP 的肿瘤学和功能结果。
结果
sRARP 时的中位 PSA 水平、出血量和控制台时间分别为 2.17ng/mL、100mL 和 136min。半数病例发现切缘阳性。中位随访时间为 1.1 年。无 30 天主要并发症。sRARP 后无患者有勃起功能。sRARP 后 1 年的尿控和生化复发（BCR）率分别为 40%和 30%。
结论
对于初始治疗为放疗或局部治疗后 PSA 失败的患者，挽救性 RARP 可能是一种可行的选择，其 BCR 率可接受。
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