前列腺癌根治术后复发的诊断和治疗

Diagnosis and treatment for local recurrence and metastasis of patients after radical prostatectomy

临床局限型前列腺癌患者在接受根治术后有一部分会发生生化复发,生化复发是肿瘤继续进展并发生临床复发或转移的前兆。术后随访中检出生化复发患者,进行恰当的评估,可以筛选出高危患者接受进一步治疗。挽救性放疗和内分泌治疗对前列腺癌根治术后复发或转移的患者有一定的疗效。本文综述了前列腺癌根治术后复发和转移的诊断方法和治疗选择的进展。

The incidence of biochemical recurrence after radical prostatectomy varies significantly and depends on numerous well-known prognostic factors. It likely occurs in at least 30% - 40% of patients who were diagnosed as localized disease and received radical prostatectomy. Because the clinical significance of biochemical recurrence is often unclear and other predictive factors relative to the recurrence are uncertain, it is difficult to select the best treatment for the patients who might relapse in the future. This review examines some of the issues associated with biological recurrence and attempts to shed some light on this common but controversial clinical scenario. Some treatment strategies were discussed in this article including salvage radiotherapy after radical prostatectomy, watchful waiting, and hormonal therapy.