新辅助内分泌治疗联合腹腔镜前列腺癌根治术治疗局部进展期前列腺癌的优势

Adevantage of neoadjuvant endocrine therapy combined with laparoscopic radical resection for locally advanced prostate cancer

目的分析新辅助内分泌治疗(NHT)联合腹腔镜下前列腺癌根治术(LRP)治疗局部进展期前列腺癌(LAPC)的优势。方法回顾性分析2016年2月至2020年6月在本院行LRP的65例LAPC患者的临床资料,根据术前是否进行内分泌治疗,将患者分为观察组(26例)和对照组(39例)。观察组在LRP前行NHT治疗,对照组直接行LRP治疗。观察两组术中及术后相关指标,分析疗效差异。结果两组患者的手术时间、术中出血量、留置导尿管时间、术后并发症及术后Gleason评分下降值比较,差异均无统计学意义(均P>0.05)。观察组的血红蛋白(Hb)下降值、白蛋白下降值低于对照组,引流管拔除时间少于对照组,术后切缘阳性率低于对照组,差异均有统计学意义(均P<0.05)。两组术后6个月骨转移确诊例数比较,差异无统计学意义(P>0.05)。结论NHT联合LRP治疗LAPC的优势在于有效减少术中失血和降低切缘阳性率,减少全身白蛋白消耗,更早拔除引流管,有利于患者术后快速恢复。

Objective To analyze the advantage of neoadjuvant endocrine therapy combined with laparoscopic radical resection of prostate cancer in the treatment of locally advanced prostate cancer.Methods Clinical data of patients with locally advanced prostate cancer who underwent laparoscopic radical resection of prostate cancer in my hospital from February 2016 to June 2020 were retrospectively analyzed.Patients were divided into observation group(26 cases)and control group(39 cases)according to whether endocrine therapy was performed preoperatively.Intraoperative and postoperative indexes of the two groups were observed to analyze the difference in efficacy.Results There were no significant differences in operation time,intraoperative blood loss,indwelling catheter time,postoperative complications and Gleason score decline between the two groups(all P>0.05).The hemoglobin(Hb)and albumin decreases in the observation group were lower than those in the control group,the drainage tube removal time was shorter than that in the control group,and the postoperative resection margin positive rate was lower than that in the control group,with statistical significance(all P<0.05).There was no significant dfference in the diagnosis of bone metastasis 6 months after surgery between the two groups(P>0.05).Conclusions Neoadjuvant endocrine therapy combined with laparoscopic radical resection of prostate cancer in the treatment of locally advanced prostate cancer can more effectively reduce intraoperative blood loss,reduce the positive rate of surgical margin,reduce systemic albumin consumption,and remove drainage tube earlier,which is conducive to rapid postoperative recovery of patients.