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高危寡转移前列腺癌行开放性根治性前列腺切除术患者的并发症和中期结果比较:来自三级参考中心的横断面研究。

Comparison of Complications and Mid-term Results for Patients who Underwent Open Radical Prostatectomy for High-Risk and Oligometastatic Prostate Cancer: A Cross-Sectional Study from a Tertiary Reference Center.

机构信息

Department of Urology, University of Health Sciences, Ümraniye Training and Research Hospital, İstanbul, Turkey.

Department of Urology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.

出版信息

Ann Surg Oncol. 2024 Nov;31(12):8438-8443. doi: 10.1245/s10434-024-16104-z. Epub 2024 Aug 28.

Abstract

BACKGROUND

This study aimed to evaluate perioperative complications and oncologic results for high-risk and oligometastatic prostate cancer patients.

METHODS

The data of patients who underwent surgery for prostate cancer in the authors' clinic between January 2012 and March 2022 were analyzed retrospectively. According to D'amico classification, 28 patients with high-risk prostate cancer and 23 patients in the oligometastatic stage were included in the study. The patients were divided into two groups: group 1 (high-risk prostate cancers) and group 2 (oligometastatic cancer). Demographic characteristics, oncologic data, pathologic data, and complications of the patients were recorded.

RESULTS

The mean age of the patients was 67.84 years (range, 52-79 years). The average follow-up period was 45.48 months for group 1 and 46.36 months for group 2 (p = 0.84). The mean hemoglobin decrease was 1.53 g/dL in group 1 and 0.69 g/dL in group 2 (p = 0.046). Five patients (17.8%) in group 1 had biochemical recurrence at 14.55 months, whereas three patients (13%) in group 2 had biochemical recurrence at 9.87 months (p = 0.646). According to Clavien-Dindo classification, major complications developed in 7.2% of the group 1 patients and in 8.6% of the group 2 patients. Surgical margin positivity was detected in 6 group 1 patients (21.4%) and 12 group 2 patients (52.2%) (p = 0.023). During the follow-up period, four patients died. Only one of the patients died of cancer.

CONCLUSION

The authors think that oligometastatic and high-risk prostate cancer surgeries do not differ significantly in terms of complications.

摘要

背景

本研究旨在评估高危和寡转移前列腺癌患者的围手术期并发症和肿瘤学结果。

方法

回顾性分析 2012 年 1 月至 2022 年 3 月作者所在诊所行前列腺癌手术患者的资料。根据 D'amico 分类,28 例高危前列腺癌患者和 23 例寡转移期患者纳入本研究。将患者分为两组:第 1 组(高危前列腺癌)和第 2 组(寡转移癌)。记录患者的人口统计学特征、肿瘤学数据、病理数据和并发症。

结果

患者的平均年龄为 67.84 岁(52-79 岁)。第 1 组的平均随访时间为 45.48 个月,第 2 组为 46.36 个月(p=0.84)。第 1 组血红蛋白平均下降 1.53 g/dL,第 2 组为 0.69 g/dL(p=0.046)。第 1 组 5 例(17.8%)患者在 14.55 个月时出现生化复发,第 2 组 3 例(13%)患者在 9.87 个月时出现生化复发(p=0.646)。根据 Clavien-Dindo 分级,第 1 组有 7.2%的患者出现严重并发症,第 2 组有 8.6%的患者出现严重并发症。第 1 组有 6 例(21.4%)患者切缘阳性,第 2 组有 12 例(52.2%)患者切缘阳性(p=0.023)。随访期间,有 4 例患者死亡。仅有 1 例患者死于癌症。

结论

作者认为寡转移和高危前列腺癌手术在并发症方面无显著差异。

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