Functional and Oncological Outcomes Following Robot-Assisted and Laparoscopic Radical Prostatectomy for Localized Prostate Cancer With a Large Prostate Volume: A Retrospective Analysis With Minimum 2-Year Follow-Ups.
Functional and Oncological Outcomes Following Robot-Assisted and Laparoscopic Radical Prostatectomy for Localized Prostate Cancer With a Large Prostate Volume: A Retrospective Analysis With Minimum 2-Year Follow-Ups.
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机器人辅助和腹腔镜自由基前列腺切除术后的功能和肿瘤学结果，用于局部前列腺癌，前列腺量很大：回顾性分析，最少2年随访。
DOI：
10.3389/fonc.2021.714680
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发表时间：
2021
影响因子：
4.7
通讯作者：
Fu B
中科院分区：
文献类型：
--
作者：
Deng W;Liu X;Liu W;Zhang C;Zhou X;Chen L;Guo J;Wang G;Fu B
我们的目的是分析机器人辅助根治性前列腺切除术 (RARP) 和腹腔镜根治性前列腺切除术 (LRP) 治疗局限性前列腺癌 (PCa) 患者的围手术期、功能性和肿瘤学结果，这些患者的特征是前列腺体积较大 (PV；≥50 ml)，至少随访 2 年。接受 RARP 和 LRP 治疗具有较大 PV 的局限性 PCa 的患者被纳入最终分析。分析两组的围手术期、功能和肿瘤学结果。两组均顺利完成所有手术，无开放转换。与 LRP 组相比，RARP 组的平均手术时间和估计失血量显着减少（分别为 139.4 分钟 vs. 159.0 分钟，p = 0.001，以及 124.2 vs. 157.3 ml，p = 0.003）。与 LRP 组相比，RARP 组患者发生 II 级或以下并发症以及高于 II 级术后并发症的比例显着降低（分别为 7.9% vs. 17.1%，p = 0.033，以及 1.6% vs. 6.7%，p = 0.047）。两组之间的 pT3 疾病、手术切缘阳性和淋巴结阳性发生率没有显着差异。此外，RARP 组和 LRP 组之间的样本格里森评分中位数没有显着差异（6 比 7，p = 0.984）。 RARP 与 LRP 相比，拔管后尿失禁的比例更高（48.4% vs. 33.3%，p = 0.021）以及术后 3 个月（65.1% vs. 50.5%，p = 0.025）和 24 个月（90.5% vs. 81.0%，p = 0.037）。 RARP 组术后 6 个月和 24 个月的中位勃起功能评分也显着高于 LRP 组（分别为 15 比 15，p = 0.042 和 15 比 13，p = 0.026）。 Kaplan-Meier 分析表明，两组之间的生化无复发生存率和累积节制比例在统计学上具有可比性（分别为 p = 0.315 和 p = 0.020）。对于手术治疗具有大前列腺（≥50 ml）的局部前列腺癌，与 LRP 相比，RARP 具有术后并发症风险较低和更好的功能保留且不影响癌症控制的趋势。
We aimed to analyze the perioperative, functional, and oncologic outcomes following robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for patients with localized prostate cancer (PCa) characterized by a large prostate volume (PV; ≥50 ml) over a minimum of 2 years follow-up. Patients undergoing RARP and LRP for localized PCa with a large PV were included in the final analysis. The perioperative, functional, and oncologic outcomes were analyzed between the two groups. All operations were successfully completed without open conversion in both groups. The mean operative time and estimated blood loss in the RARP group were significantly decreased compared to those in the LRP group (139.4 vs. 159.0 min, p = 0.001, and 124.2 vs. 157.3 ml, p = 0.003, respectively). Patients in the RARP arm had significantly lower proportions of grade II or lower and of higher than grade II postoperative complications compared with those in the LRP group (7.9% vs. 17.1%, p = 0.033, and 1.6% vs. 6.7%, p = 0.047, respectively). No significant differences in terms of the rates of pT3 disease, positive surgical margin, and positive lymph node were noted between the two groups. Moreover, no significant difference in the median specimen Gleason score was observed between the RARP and LRP groups (6 vs. 7, p = 0.984). RARP vs. LRP resulted in higher proportions of urinary continence upon catheter removal (48.4% vs. 33.3%, p = 0.021) and at 3 (65.1% vs. 50.5%, p = 0.025) and 24 (90.5% vs. 81.0%, p = 0.037) months post-operation. The median erectile function scores at 6 and 24 months post-operation in the RARP arm were also significantly higher than those in the LRP arm (15 vs. 15, p = 0.042, and 15 vs. 13, p = 0.026, respectively). Kaplan–Meier analyses indicated that the biochemical recurrence-free survival and accumulative proportion of continence were statistically comparable between the two groups (p = 0.315 and p = 0.020, respectively). For surgically managing localized PCa with a large prostate (≥50 ml), RARP had a tendency toward a lower risk of postoperative complications and better functional preservation without cancer control being compromised when compared to LRP.
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影响因子：
4.5
作者：
Foley, CL;Bott, SRJ;Kirby, RS
通讯作者：
Kirby, RS
影响因子：
2.6
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