SALVAGE RADICAL PROSTATECTOMY - OUTCOME MEASURED BY SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS
SALVAGE RADICAL PROSTATECTOMY - OUTCOME MEASURED BY SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS
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DOI：
10.1097/00005392-199501000-00037
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发表时间：
1995-01-01
影响因子：
6.6
通讯作者：
SCARDINO, PT
中科院分区：
文献类型：
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作者：
ROGERS, E;OHORI, M;SCARDINO, PT
我们回顾了40例局部复发癌患者的补救性根治性直肠癌切除术的经验，以评估目前的并发症发生率和使用前列腺特异性抗原（PSA）作为治疗结果的指标的结果，并确定更好的标准，选择合适的候选人进行这种操作。大多数复发性癌症通过直肠指检（26例患者）或血清PSA水平升高（10例）检测。该手术在技术上具有挑战性，6例直肠损伤（15%），2例需要临时结肠造口术。严重的技术并发症是更常见的（31%）在29例患者进行盆腔淋巴结切除术时，初始放疗比11例单纯外照射治疗（9%）。31例可评估患者中18例（58%）持续存在尿失禁，9例用人工尿道括约肌成功纠正。共有21例（54%）患者有病理学晚期疾病（精囊浸润和/或淋巴结转移）。术前PSA水平与病理分期相关（p <0.05），而与临床分期、活检分级无关（p <0.05）。
We reviewed our experience with salvage radical prostatectomy for locally recurrent cancer in 40 patients to assess the current complication rate and the results using prostate specific antigen (PSA) as an indicator of treatment outcome and to identify better criteria for the selection of appropriate candidates for this operation. Most recurrent cancers were detected by digital rectal examination (26 patients) or increasing serum PSA levels (10). The operation was technically challenging, with 6 rectal injuries (15%), 2 requiring temporary colostomy. Serious technical complications were more common (31%) among the 29 patients who underwent pelvic lymphadenectomy at the time of initial radiotherapy than among the 11 treated with external irradiation alone (9%). Urinary incontinence persisted in 18 of 31 evaluable patients (58%) and was successfully corrected with an artificial urinary sphincter in 9.A total of 21 patients (54%) had pathologically advanced disease (seminal vesicle invasion and/or lymph node metastases). Preoperative PSA levels but not clinical stage or biopsy grade correlated with pathological stage (p