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局限性前列腺癌的部分前列腺切除术。

Partial prostatectomy for localized prostate cancer.

作者信息

Wu Yue, Wang Chengwei, Long Xiangyu, Wang Tao, Wang Zhihua, Yang Chunguang, Wang Shaogang

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

World J Urol. 2024 Sep 27;42(1):543. doi: 10.1007/s00345-024-05242-4.

Abstract

BACKGROUND AND OBJECTIVE

Localized prostate cancer treatment aims to balance cancer control with preserving urinary and erectile function. While focal ablative therapies have emerged, their uncertain prognosis prompts exploration of partial prostatectomy. We systematically reviewed its efficacy as a primary treatment, particularly in low-to-intermediate-risk patients.

METHODS

Our review comprehensively analyzed existing studies on partial prostatectomy for localized cancer. We focused on patient selection, surgical techniques, and postoperative outcomes, emphasizing tumor control, continence, and erectile function. Studies involving multiparametric MRI and targeted biopsies for candidate selection were included.

KEY FINDINGS AND LIMITATIONS

Partial prostatectomy, encompassing various techniques, demonstrates promising short-term outcomes in tumor control and functional preservation. Preoperative imaging and biopsy aid in candidate selection. However, longer-term data on cancer recurrence are limited, warranting further investigation. Heterogeneity among studies and the lack of standardized follow-up protocols are notable limitations.

CONCLUSIONS AND CLINICAL IMPLICATIONS

Partial prostatectomy offers a minimally invasive and effective treatment option for localized prostate cancer, particularly in selected patients. Preoperative imaging and biopsy play crucial roles in patient selection, while standardized follow-up protocols are needed to assess long-term outcomes. Future research should focus on elucidating its precise role and optimizing patient selection criteria, contributing to improved prostate cancer management strategies.

ADVANCING PRACTICE

Partial prostatectomy is explored for localized prostate cancer treatment, aiming to balance cancer control with preserving function. Short-term outcomes are promising, but long-term data on recurrence are lacking. Further research is needed to optimize patient selection and standardize follow-up protocols.

摘要

背景与目的

局限性前列腺癌的治疗旨在平衡癌症控制与保留泌尿和勃起功能。虽然局部消融疗法已出现,但其预后不确定促使人们探索部分前列腺切除术。我们系统回顾了其作为主要治疗方法的疗效,特别是在低至中危患者中的疗效。

方法

我们的综述全面分析了现有的关于局限性癌症部分前列腺切除术的研究。我们关注患者选择、手术技术和术后结果,重点是肿瘤控制、控尿和勃起功能。纳入了涉及多参数MRI和靶向活检以进行候选者选择的研究。

主要发现与局限性

涵盖各种技术的部分前列腺切除术在肿瘤控制和功能保留方面显示出有前景的短期结果。术前成像和活检有助于候选者选择。然而,关于癌症复发的长期数据有限,需要进一步研究。研究之间的异质性和缺乏标准化的随访方案是显著的局限性。

结论与临床意义

部分前列腺切除术为局限性前列腺癌提供了一种微创且有效的治疗选择,特别是在特定患者中。术前成像和活检在患者选择中起关键作用,而需要标准化的随访方案来评估长期结果。未来的研究应专注于阐明其确切作用并优化患者选择标准,以改进前列腺癌管理策略。

推进实践

探索部分前列腺切除术用于局限性前列腺癌治疗,旨在平衡癌症控制与保留功能。短期结果有前景,但缺乏关于复发的长期数据。需要进一步研究以优化患者选择并标准化随访方案。

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