Ambrosini Francesca, Hagemann Johanna, Pose Randi, Maurer Tobias, Heinzer Hans, Michl Uwe, Steuber Thomas, Budäus Lars, Terrone Carlo, Tennstedt Pierre, Haese Alexander, Tilki Derya, Graefen Markus, Nagaraj Yamini, Salomon Georg
Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
IRCCS Ospedale Policlinico San Martino, Genova, Italia.
World J Urol. 2024 Dec 2;43(1):7. doi: 10.1007/s00345-024-05322-5.
To determine the surgical and oncologic outcomes of salvage radical prostatectomy (sRP) after FT failure.
Patients who consecutively underwent primary RP or sRP after FT failure between 2008 and 2022 were retrospectively selected. Primary or sRP were performed with either a robot-assisted or open approach. All surgeries were performed by surgeons with experience of ≥ 500 cases. Biochemical recurrence-free survival (BFS), intra- and postoperative surgical and functional outcomes were assessed. To evaluate the impact of surgical setting, propensity score (PS) matching was performed.
80 patients received sRP. Outcomes were analyzed using PS-matched cohorts (203 RPs vs. 68 sRPs). After a median follow-up of 25.4 months, sRP and RP had equal BFS (24mo-BFS: 72.4% vs. 76.0% (p = 0.8)). No statistically significant differences were found between sRP and RP in terms of median operative time (OT) (171 min vs. 168 min), estimated blood loss (EBL) (500 ml vs. 500 ml), length of hospital stay (LOS) (7 days vs. 7 days) and time to catheter removal (11 days vs. 11 days) and 1-year continence rates (all standardized mean differences ≤ 0.1). The main limitation is the retrospective study design.
In the hands of experienced surgeons, sRP after FT offered comparable surgical and oncologic outcomes as RP in a primary setting.
确定氟他胺（FT）治疗失败后挽救性根治性前列腺切除术（sRP）的手术和肿瘤学结局。
回顾性选取2008年至2022年间在FT治疗失败后连续接受初次根治性前列腺切除术（RP）或sRP的患者。初次或sRP采用机器人辅助或开放手术方式。所有手术均由经验≥500例的外科医生进行。评估无生化复发生存期（BFS）、术中和术后的手术及功能结局。为评估手术方式的影响，进行倾向评分（PS）匹配。
80例患者接受了sRP。使用PS匹配队列（203例RP与68例sRP）分析结局。中位随访25.4个月后，sRP和RP的BFS相当（24个月BFS：72.4%对76.0%（p = 0.8））。sRP和RP在中位手术时间（OT）（171分钟对168分钟）、估计失血量（EBL）（500毫升对500毫升）、住院时间（LOS）（7天对7天）、拔管时间（11天对11天）和1年控尿率方面均未发现统计学显著差异（所有标准化均值差异≤0.1）。主要局限性是回顾性研究设计。
在经验丰富的外科医生手中，FT治疗失败后行sRP与初次手术行RP的手术和肿瘤学结局相当。
