机器人辅助与开放前列腺癌根治术切缘阳性情况比较

发布时间：2018-10-14 17:30

【摘要】：目的比较单术者应用机器人辅助与开放前列腺癌根治术两种手术方式进行前列腺癌切除时肿瘤切缘阳性情况。方法 2009年1月至2017年5月期间,我院单术者分别应用开放前列腺癌根治术治疗的81例前列腺癌患者及机器人辅助前列腺癌根治术治疗的306例前列腺癌患者入组本研究。术后病理切缘阳性定义为前列腺癌根治标本切缘墨染标记处可见肿瘤细胞。通过我科前列腺癌随访数据库提取所有患者的年龄、术前前列腺特异抗原(PSA)水平、术后病理Gleason评分、病理T分期、上下切缘阳性情况等资料,使用倾向评分匹配法对两种术式的数据进行配对以保证其一致性,比较两种术式切缘阳性情况的差异。采用多因素logistic回归分析明确切缘阳性的独立影响因素。结果将两组患者的年龄、术前PSA水平、术后病理Gleason评分、病理T分期作为预测变量进行倾向评分匹配后成功配对81对病例,开放前列腺癌根治术组和机器人辅助前列腺癌根治术组上切缘阳性率分别为22.2%(18/81)、18.5%(15/81),下切缘阳性率分别为29.6%(24/81)、30.9%(25/81),总切缘阳性率分别为38.3%(31/81)、38.3%(31/81),两组间差异均无统计学意义。多因素logistic回归分析术前PSA水平及病理T分期是切缘阳性的独立影响因素(P=0.011,P=0.000)。结论机器人辅助前列腺癌根治术能够提供不亚于开放手术的肿瘤切除的完整性。
[Abstract]:Objective to compare the positive rate of tumor margin between robotic assisted and open prostatectomy for prostate cancer resection. Methods from January 2009 to May 2017, 81 patients with prostate cancer treated by open radical prostatectomy and 306 patients with prostate cancer treated by robot-assisted radical prostatectomy were enrolled in this study. Pathological margin positive was defined as tumor cells in the incised margin of prostate cancer specimens. The age, (PSA) level of prostate specific antigen (PSA), postoperative pathological Gleason score, pathological T stage, positive condition of upper and lower incisal margin were obtained from our follow-up database of prostate cancer. The data of the two operations were matched by the tendency score matching method to ensure the consistency, and the difference of the positive conditions between the two operations was compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of positive margin. Results Age, preoperative PSA level, postoperative pathological Gleason score, pathological T stage were matched as predictive variables and 81 pairs of patients were matched successfully. The positive rates of upper incisor and lower incisor were 22.2% (18 / 81), 18.5% (15 / 81), 29.6% (24 / 81), 30.9% (25 / 81), 38.3% (31 / 81) and 38.3% (31 / 81), respectively. Multivariate logistic regression analysis showed that preoperative PSA level and pathological T stage were independent factors of positive margin (P0. 011 / P0. 000). Conclusion Robotic assisted radical prostatectomy can provide no less integrality than open surgery.
【作者单位】：第二军医大学长海医院泌尿外科;
【分类号】：R737.25

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