215例前列腺癌治疗分析

发布时间：2018-05-03 02:30

  本文选题：前列腺肿瘤 + 根治性前列腺切除　； 参考：《中国现代医学杂志》2017年08期

【摘要】：目的探讨耻骨后根治性前列腺切除,结合个体化治疗高危前列腺癌的疗效。方法 94例高危前列腺癌中70例用3个月新辅助内分泌治疗,耻骨后根治性前列腺切除时行直肠膀胱隔(Denonvillier)筋膜前脂肪垫、前列腺、双侧神经血管束整块切除,对淋巴管造影提示可疑淋巴结转移49例给予扩大淋巴清扫,其余患者按耻骨后根治性前列腺切除(Walsh)方法行耻骨后前列腺癌切除。术后对≥p T3a、Gleason分级≥8、淋巴结转移和切缘阳性者给予6个月辅助内分泌治疗或局部外放疗。比较高危与中低危前列腺癌的手术时间、术中出血量、相关并发症和3及5年生存情况。结果耻骨后根治性前列腺切除治疗高危与中低危前列腺癌在手术时间、术中出血量、相关并发症、3年、5年总生生存率及肿瘤特异性生存率之间差异无统计学意义(P0.05)。结论耻骨后根治性前列腺切除,结合术后辅助内分泌治疗或局部外放疗的个体化处理,有望使部分局限性高危前列腺癌达到与中低危前列腺癌相似的治疗效果。
[Abstract]:Objective to investigate the curative effect of posterior radical prostatectomy combined with individualized treatment for high risk prostate cancer. Methods 70 cases of high risk prostate cancer were treated with 3 months neoadjuvant endocrine therapy. Rectum bladder septum Denonvillier prefascial fat pad, prostate, bilateral nerve and vascular bundle were removed. Enlarged lymphotomy was performed in 49 patients with suspected lymph node metastasis, and the rest patients underwent retropubic prostatectomy according to retropubic radical prostatectomy (Walsh). Patients with Gleason grade 鈮，

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