新辅助内分泌治疗对T3N0M0期前列腺癌根治术围手术期疗效的影响研究

发布时间：2018-04-27 09:07

本文选题：新辅助内分泌治疗 + 前列腺癌　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:探究新辅助内分泌药物疗法对T3N0M0期前列腺癌根治术围手术期疗效的影响。方法:通过回顾性地收集并分析自2010年1月至2016年10月,青岛大学附属青岛市市立医院泌尿外科收治的64例T3N0M0期前列腺癌患者的住院病例资料,根据治疗方式的不同分为联合治疗组(43例)和单纯手术组(21例)。手术均成功完成。行前列腺癌根治术治疗前两组患者的基本情况(年龄、体质指数、前列腺体积、PSA水平)的差异无统计学意义(PO.05),通过统计学软件对比分析两组患者的手术时间、术中失血量、术后住院时间、切缘阳性率、术后Gleason评分、术后尿管留置时间、控尿恢复时间、术后各种手术相关并发症发生率等临床数据资料,来探究新辅助内分泌治疗对T3N0M0期前列腺癌患者根治术围手术期疗效的影响。结果:两组患者均成功实施腹腔镜前列腺癌根治术,无中转开放。新辅助内分泌治疗可以明显使T3N0M0期肿瘤的前列腺体积减小,使血清PSA水平明显降低。两组的手术时间、术中失血量、术后住院时间、盆腔引流时间、术后Gleason评分、尿管留置时间、手术相关的并发症发生率等差异均无显著统计学意义(P0.05)。联合治疗组的术中控尿恢复时间低于单纯手术组(P0.05),联合治疗组的手术肿瘤切缘阳性率低于单纯手术组的肿瘤切缘阳性率,差异均有显著统计学意义(P0.05)。结论:新辅助内分泌治疗联合前列腺癌根治术治疗T3N0M0期前列腺癌是安全并且可行的。新辅助内分泌治疗能够明显减小T3N0M0期前列腺癌的前列腺体积、显著降低血清PSA水平。新辅助内分泌治疗对于T3N0M0期前列腺癌患者的围手术期一般指标并没有显著影响,并未明显增加手术风险。新辅助内分泌治疗可以降低T3N0M0期前列腺癌的手术肿瘤切缘阳性率,可以相应缩短根治术后控尿恢复时间。
[Abstract]:Objective: to investigate the effect of neoadjuvant endocrine therapy on perioperative efficacy of T3N0M0 radical prostatectomy for prostate cancer. Methods: from January 2010 to October 2016, 64 cases of T3N0M0 stage prostate cancer were collected and analyzed retrospectively from the Department of Urology, Qingdao City Hospital affiliated to Qingdao University. According to the different treatment methods, the patients were divided into combined treatment group (n = 43) and simple operation group (n = 21). The operation was completed successfully. There was no significant difference between the two groups (age, body mass index, prostate volume PSA level) before radical prostatectomy. The time of operation and blood loss during operation were analyzed by statistical software. Clinical data such as postoperative hospitalization time, positive rate of incision margin, postoperative Gleason score, postoperative urinary catheter indwelling time, recovery time of controlled urine, incidence of postoperative complications and other clinical data, etc. To explore the effect of neoadjuvant endocrine therapy on perioperative outcome in patients with T3N0M0 prostate cancer. Results: laparoscopic radical prostatectomy was performed successfully in both groups. Neoadjuvant endocrine therapy can significantly reduce the prostate volume and serum PSA level of T3N0M0 stage tumors. There were no significant differences in operation time, blood loss, postoperative hospitalization time, pelvic drainage time, postoperative Gleason score, urinary catheter indwelling time and the incidence of complications related to operation between the two groups (P 0.05). The recovery time of controlled urine in the combined treatment group was lower than that in the simple operation group (P 0.05), and the positive rate of the surgical resection margin in the combined treatment group was lower than that in the simple operation group (P 0.05). Conclusion: neoadjuvant endocrine therapy combined with radical prostatectomy for T3N0M0 stage prostate cancer is safe and feasible. Neoadjuvant endocrine therapy can significantly reduce prostate volume and serum PSA level of T3N0M0 prostate cancer. Neo-adjuvant endocrine therapy has no significant effect on perioperative parameters of patients with T3N0M0 prostate cancer and does not significantly increase the risk of surgery. Neoadjuvant endocrine therapy can reduce the positive rate of resection margin of prostate cancer in T3N0M0 stage and shorten the recovery time of urinary control after radical operation.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

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