腹腔镜下根治性前列腺切除术在寡转移前列腺癌中应用的临床疗效与安全性分析

Analysis of clinical efficacy and safety of laparoscopic radical prostatectomy in oligometastatic prostate cancer patients

目的:研究寡转移前列腺癌患者行腹腔镜根治性前列腺切除术的临床疗效及围手术期并发症情况。方法:回顾性分析28例寡转移前列腺癌患者(寡转移组)和95例局限性前列腺癌患者(局限组)行腹腔镜下根治性前列腺切除术的相关数据。统计分析寡转移组和局限组术前及术后血清前列腺特异性抗原(PSA)水平、手术并发症发生率及住院时间等指标。结果:寡转移组及局限组患者均顺利完成手术,术中无严重并发症发生。围手术期寡转移组轻度和重度并发症发生率分别为21.4%、0.0%,局限组分别为22.1%、3.2%,均差异无统计学意义(P>0.05)。术后1年PSA水平均明显下降。结论:寡转移前列腺癌非手术禁忌证。多数患者经过新辅助治疗后可行根治性前列腺切除术,围手术期并发症与局限性前列腺癌患者相比未见明显升高,提示基于手术治疗的多学科治疗方案,有望改善患者疾病进展,延长生存期。

Objective:To evaluate the clinical efficacy and perioperative complications of radical prostatectomy in patients with oligometastatic prostate cancer.Method:The clinical data of 28 oligometastatic prostate cancer patients(the oligometastatic group)and 95 localized prostate cancer patients(the localized group)performed with laparoscopic radical prostatectomy were evaluated.The preoperative and postoperative PSA levels,complications incidence and hospital stays were analyzed between two groups.Result:Laparoscopic radical prostatectomy was performed successfully in both groups,there was no serious complications occurred during the operation.The incidence of minor complication and major complication was 21.4%vs.0.0%in the oligometastatic group,and was 22.1%vs.3.2%in the localized group respectively.Differences between two groups were no statistical significance(P>0.05),the PSA level decreased significantly in both groups after one years of the operation.Conclusion:Oligometastatic prostate cancer is no longer a contraindication to laparoscopic radical prostatectomy.Most patients could get the opportunity to undergo a radical prostatectomy after neoadjuvant hormonal therapy,there was no significant increase in perioperative complications compared with localized prostate cancer.It suggests that multidisciplinary therapy based on radical prostatectomy can delay the cancer progression and exetend the survival time.