An evaluation of the decreasing incidence of positive surgical margins in a large retropubic prostatectomy series.
An evaluation of the decreasing incidence of positive surgical margins in a large retropubic prostatectomy series.
复制标题
对大型耻骨后前列腺切除术系列中手术切缘阳性发生率降低的评估。
DOI：
10.1097/01.ju.0000098604.09395.27
复制
发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Walsh,PatrickC
中科院分区：
文献类型：
--
作者：
Han,Misop;Partin,AlanW;Chan,DavidY;Walsh,PatrickC
目的：阳性切缘对前列腺癌根治性耻骨后前列腺切除术（RRP）后生化无复发生存率有不利影响。我们回顾性地回顾了在一所大学泌尿学专业接受RRP的大量男性，以确定在过去20年中器官受限（OC）疾病和阳性手术切缘（SM+）发生率的变化。材料和方法1982年至2001年间，9035名男性在同一机构接受了临床局限性前列腺癌（T1至T3a）的RRP。我们比较了该人群中OC病和SM+的发病率。结果随着时间的推移，男性患卵巢癌的比例越来越高。随着时间的推移，总体RRP人群中SM+的发生率急剧下降。然而，在患有非器官局限性疾病（pT3）的男性中，SM+的比例稳定且持续升高（22.7%至27.8%），从20世纪80年代初开始下降（53%）。结论：在过去的20年里，前列腺癌早期检测项目的广泛开展导致了本院临床局限性前列腺癌患者的分期下降。SM+男性百分比的下降是由于患有器官局限性疾病的男性人数增加。这些结果表明，在整个RRP人群中，手术切缘率的下降很可能是由于分期转移和患者选择的改进，而不是手术技术的重大改进。pT3疾病男性中SM+的稳定百分比表明需要继续评估手术技术并需要有效的辅助治疗。
PurposePositive surgical margins adversely affect biochemical recurrence-free survival after radical retropubic prostatectomy (RRP) for prostate cancer. We retrospectively reviewed a large series of men who underwent RRP at a single academic university urology program to define the change in the incidence of organ confined (OC) disease and positive surgical margin (SM+) during the last 2 decades.Materials and MethodsBetween 1982 and 2001, 9,035 men underwent RRP for clinically localized prostate cancer (T1 to T3a) at a single institution. We compared the incidences of OC disease and SM+ in this population.ResultsAn increasing proportion of men presented with OC disease over time. The incidence of SM+ in the overall RRP population decreased dramatically over time. However, in men with nonorgan confined disease (pT3), the proportion with SM+ was stable and consistently elevated (22.7% to 27.8%), after the initial decrease from the early 1980s (53%).ConclusionsWidespread early detection programs for prostate cancer resulted in a downward stage migration in men presenting with clinically localized prostate cancer at our institution during the last 2 decades. The decrease in the percentage of men with SM+ was due to the increasing number of men with organ confined disease. These results imply that the decrease in surgical margin rates in the overall RRP population is most likely due to stage migration and improved patient selection, rather than major improvements in surgical technique. The stable percentage of SM+ among men with pT3 disease dictates the need for continued evaluation of surgical technique and the need for effective adjuvant therapy.
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影响因子：
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作者：
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DOI：
--
发表时间：
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期刊：
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影响因子：
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DOI：
--
发表时间：
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期刊：
The Prostate
影响因子：
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作者：
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