https://scholars.lib.ntu.edu.tw/handle/123456789/542090
標題: | Laparoscopic radical prostatectomy monotherapy, a more aggressive yet less invasive option, is oncologically effective in selected men with high-risk prostate cancer having only one d'amico risk factor: Experience from an asian tertiary referral center | 作者: | Tai H.-C. Lai M.-K. CHAO-YUAN HUANG SHUO-MENG WANG KUO-HOW HUANG CHUNG-HSIN CHEN Chung S.-D. SHIH-CHIEH CHUEH HONG-JENG YU YEONG-SHIAU PU |
公開日期: | 2014 | 卷: | 28 | 期: | 2 | 起(迄)頁: | 165-171 | 來源出版物: | Journal of Endourology | 摘要: | Purpose: To present oncologic results of laparoscopic radical prostatectomy (LRP) monotherapy for men with high-risk, localized prostate cancer, and to find factors associated with a good prognosis via surgery alone. Patients and Methods: Between 2002 and 2009, 241 men underwent LRP at an Asian tertiary referral center. Among them, we retrospectively identified 85 (35.3%) men who met the D'Amico's high-risk criteria: Prostate-specific antigen level >20 ng/mL, Gleason score of 8 to 10, or clinical stage ?T2c. Perioperative parameters were analyzed against biochemical recurrence (BCR)-free survival. Results: At a median follow-up of 54 months, BCR developed in 28 (34.1%), with an actuarial BCR-free survival rate of 63.3% at 5 years. Pathologically, 37.6% of the men had organ-confined (OC) disease. Positive surgical margins (PSM) were identified in 49.4% of the patients. A favorable pathologic outcome, defined as OC(+)PSM(-), was observed in 24 patients and associated with a 5-year BCR-free survival rate of 87.0%, compared with 100%, 54.0%, and 46.4% in men with OC(+)PSM(+), OC(-)PSM(-) and OC(-)PSM(+) disease (log-rank, P=0.008). The overall positive lymph node rate was 14.1%. Men (65.9%) with only one D'Amico risk factor had a 5-year BCR-free survival rate of 76.9%, compared with 34.6% in men (34.1%) with ?2 risk factors (log-rank, P<0.001). Conclusions: Radical prostatectomy monotherapy performed laparoscopically or robotically appears to be an option for high-risk prostate cancer, especially in men with a single D'Amico risk factor. Men with ?2 risk factors are more prone for BCR to develop after surgery and may need second-line therapy. ? Copyright 2014, Mary Ann Liebert, Inc. 2014. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84893511891&doi=10.1089%2fend.2013.0118&partnerID=40&md5=a5b02cbfaa0da068acb1276ff3916d83 https://scholars.lib.ntu.edu.tw/handle/123456789/542090 |
ISSN: | 0892-7790 | DOI: | 10.1089/end.2013.0118 | SDG/關鍵字: | Aged; Asia; Follow-Up Studies; Humans; Laparoscopy; Male; Middle Aged; Neoplasm Grading; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms; Retrospective Studies; Risk Factors; Survival Rate; Tertiary Care Centers |
顯示於: | 醫學系 |
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