山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (1): 21-25.doi: 10.6040/j.issn.1671-7554.0.2018.1226
姚旭东
YAO Xudong
摘要: 前列腺癌是全球男性最常见的恶性肿瘤之一。局部晚期前列腺癌是指肿瘤突破了前列腺包膜,侵犯精囊或邻近组织(T3a-T4),和/或合并有区域淋巴结转移,没有远处转移的前列腺癌(cT3a-4N0-1M0)。局部晚期前列腺癌恶性程度高,复发转移率高。过去由于较高的手术切缘阳性率和术后并发症发生率,局部晚期前列腺癌不推荐手术治疗。然而,手术技术的改进及综合内分泌治疗使得这些患者的预后优于局部放疗或放疗联合内分泌治疗。主要针对局部晚期前列腺癌外科治疗的合理性与优势、预后、扩大淋巴结清扫意义及并发症等进行述评。
中图分类号:
| [1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018[J]. CA Cancer J Clin, 2018, 68(1): 7-30. [2] Chen WQ, Zheng RS, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132. [3] Chen R, Ren SC, Chinese Prostate Cancer Consortium, et al. Prostate cancer in Asia: a collaborative report[J]. Asian J Urol, 2014, 1(1): 15-29. [4] DAmico AV, Schultz D, Loffredo M, et al. Biochemical outcome following external beam radiation therapy with or without androgen suppression therapy for clinically localized prostate cancer[J]. JAMA, 2000, 284(10): 1280-1283. [5] Mottet N, Bellmunt J, Bolla M, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent[J]. Eur Urol, 2017, 71(4): 618-629. [6] Veeratterapillay R, Goonewardene SS, Barclay J, et al. Radical prostatectomy for locally advanced and metastatic prostate cancer[J]. Ann R Coll Surg Engl, 2017, 99(4): 259-264. [7] Suardi N, DellOglio P, Gallina A, et al. Evaluation of positive surgical margins in patients undergoing robot-assisted and open radical prostatectomy according to preoperative risk groups[J]. Urol Oncol, 2016, 34(2): 57.e1-57.e7. doi:10.1016/j.urolonc.2015.08.019. [8] Hager B, Kraywinkel K, Keck B, et al. Increasing use of radical prostatectomy for locally advanced prostate cancer in the USA and Germany: a comparative population-based study[J]. Prostate Cancer Prostatic Dis, 2017, 20(1): 61-66. [9] Mitchell CR, Boorjian SA, Umbreit EC, et al. 20-Year survival after radical prostatectomy as initial treatment for cT3 prostate cancer[J]. BJU Int, 2012, 110(11): 1709-1713. [10] Srivatsa N, Nagaraja H, Shweta S, et al. Radical prostatectomy for locally advanced prostate cancers-review of literature[J]. Indian J Surg Oncol, 2017, 8(2): 175-180. [11] Briganti A, Karnes JR, Da Pozzo LF, et al. Two positive nodes represent a significant cut-off value for cancer specific survival in patients with node positive prostate cancer. A new proposal based on a two-institution experience on 703 consecutive N+ patients treated with radical prostatectomy, extended pelvic lymph node dissection and adjuvant therapy[J]. Eur Urol, 2009, 55(2): 261-270. [12] Nickers P, Lartigau E. Re: Chao-Yu Hsu, Steven Joniau, Raymond Oyen et al. Outcome of surgery for clinical unilateral T3a prostate cancer: a single-institution experience. Eur Urol 2007; 51: 121-9[J]. Eur Urol, 2007, 52(2): 612. doi:10.1016/j.eururo.2007.03.048. [13] Freedland SJ, Partin AW, Humphreys EB, et al. Radical prostatectomy for clinical stage T3a disease[J]. Cancer, 2007, 109(7): 1273-1278. [14] Joniau S, Hsu CY, Gontero P, et al. Radical prostatectomy in very high-risk localized prostate cancer: long-term outcomes and outcome predictors[J]. Scand J Urol Nephrol, 2012, 46(3): 164-171. [15] Moltzahn F, Karnes J, Gontero P, et al. Predicting prostate cancer-specific outcome after radical prostatectomy among men with very high-risk cT3b/4 PCa: a multi-institutional outcome study of 266 patients[J]. Prostate Cancer Prostatic Dis, 2015, 18(1): 31-37. [16] Johnstone PA, Ward KC, Goodman M, et al. Radical prostatectomy for clinical T4 prostate cancer[J]. Cancer, 2006, 106(12): 2603-2609. [17] Sussman R, Carvalho FLF, Harbin A, et al. Survival and secondary interventions following treatment for locally-advanced prostate cancer[J]. Can J Urol, 2018, 25(5): 9516-9524. [18] Moschini M, Briganti A, Murphy CR, et al. Outcomes for patients with clinical lymphadenopathy treated with radical prostatectomy[J]. Eur Urol, 2016, 69(2): 193-196. [19] Gözen AS, Akin Y, Ates M, et al. Impact of laparoscopic radical prostatectomy on clinical T3 prostate cancer: experience of a single centre with long-term follow-up[J]. BJU Int, 2015, 116(1): 102-108. [20] Mayor de Castro J, Caño Velasco J, Aragón Chamizo J, et al. Locally advanced prostate cancer. Definition, diagnosis and treatment[J]. Arch Esp Urol, 2018, 71(3): 231-238. [21] Zhao F, Shen JY, Yuan ZG, et al. Trends in treatment for prostate cancer in China: preliminary patterns of care study in a single institution[J]. J Cancer, 2018, 9(10): 1797-1803. [22] Mattei A, Fuechsel FG, Bhatta Dhar N, et al. The template of the primary lymphatic landing sites of the prostate should be revisited: results of a multimodality mapping study[J]. Eur Urol, 2008, 53(1): 118-125. [23] Kim KH, Rha KH. Re: Steven Joniau, Laura Van den Bergh, Evelyne Lerut, et al. Mapping of pelvic lymph node metastases in prostate cancer. Eur Urol 2013; 63: 450-8[J]. Eur Urol, 2013, 64(3): e55-e56. doi:10.1016/j.eururo.2013.05.038. [24] Moschini M, Fossati N, Abdollah F, et al. Determinants of long-term survival of patients with locally advanced prostate cancer: the role of extensive pelvic lymph node dissection[J]. Prostate Cancer Prostatic Dis, 2016, 19(1): 63-67. [25] Pang C, Guan YY, Li HB, et al. Urologic cancer in China[J]. Jpn J Clin Oncol, 2016, 46(6): 497-501. [26] Yao XD, Liu XJ, Zhang SL, et al. Perioperative complications of radical retropubic prostatectomy in patients with locally advanced prostate cancer: a comparison with clinically localized prostate cancer[J]. Asian J Androl, 2013, 15(2): 241-245. [27] Gandaglia G, De Lorenzis E, Novara G, et al. Robot-assisted radical prostatectomy and extended pelvic lymph node dissection in patients with locally-advanced prostate cancer[J]. Eur Urol, 2017, 71(2): 249-256. [28] 潘家骅, 迟辰斐, 董柏君, 等. 多西他赛联合全雄阻断新辅助疗法治疗高危局部进展性前列腺癌的安全性[J]. 上海交通大学学报(医学版), 2017, 37(6): 797-802. PAN Jiahua, CHI Chenfei, DONG Baijun, et al. Safety of neoadjuvant chemo-hormonal therapy by the combination of docetaxel and maximal androgen blockage for locally advanced prostate cancer[J]. Journal of Shanghai Jiaotong University(Medical Science), 2017, 37(6): 797-802. |
| [1] | 王兴山,张浩天,张云峰,周一新. 旋转铰链膝在复杂初次膝关节置换中的应用及临床疗效[J]. 山东大学学报 (医学版), 2026, 64(4): 51-57. |
| [2] | 罗淇,王霞,姜孟. 脑功能网络分析在失语症诊疗中的应用:病理机制分析、临床诊断与疗效评价[J]. 山东大学学报 (医学版), 2025, 63(8): 111-126. |
| [3] | 苗壮,刘培来. 双柱活动平台单髁假体治疗膝关节前内侧骨关节炎的中期疗效[J]. 山东大学学报 (医学版), 2025, 63(7): 62-67. |
| [4] | 国科,陈绪军,郑宝石,施超,黄克力,曹勇,陈军,吴东凯,张晓慎,罗俊辉,申林,莫绪明,杨岷,王晓武,雷印胜,田茂州,王振东,孟自力,孙忠东,李有金,陆辉辉,孟春营,高峰,陈黔苏,郭能瑞,柳德斌,张楠,林宇,陈文生,宋保国,方智,王海晨,廖晓波,徐朝军. 快通道拔管在全动脉冠脉旁路移植术的多中心临床效果[J]. 山东大学学报 (医学版), 2025, 63(5): 26-32. |
| [5] | 王建旭,彭晓辉,丰浩田,安森博,董恣豪,黄子帅,刘喆,杨光. 应用内支撑技术辅助膝关节前交叉韧带全内重建术近期疗效观察[J]. 山东大学学报 (医学版), 2025, 63(3): 22-27. |
| [6] | 黄艳,周应芳,彭超. 青少年子宫内膜异位症的管理要点和策略[J]. 山东大学学报 (医学版), 2025, 63(10): 8-12. |
| [7] | 贾振存,吴晨睿,赵德龙,朱可嘉,丁森泰. 八宝丹胶囊联合米拉贝隆治疗女性膀胱过度活动症的有效性与安全性[J]. 山东大学学报 (医学版), 2025, 63(10): 72-79. |
| [8] | 孙晓丹,杨创. 多黏菌素B治疗ICU耐碳青霉烯类革兰阴性杆菌感染患者的效果[J]. 山东大学学报 (医学版), 2024, 62(7): 72-77. |
| [9] | 冯绪强,高萍,孙超,陶琳,闫根全,冷冰. 替加环素治疗感染性疾病临床疗效及影响因素[J]. 山东大学学报 (医学版), 2024, 62(12): 11-20. |
| [10] | 吴磊丽,蔡华丽,孙德胜,魏蔚霞. 超声引导穿刺硬化术联合地诺孕素治疗卵巢子宫内膜异位囊肿的疗效[J]. 山东大学学报 (医学版), 2023, 61(6): 65-69. |
| [11] | 邵长秀,贺青卿,庄晓璇,周鹏,李小磊,岳涛,徐婧,李陈钰,郭浩男,庄大勇. 甲状旁腺全切加微量腺体自体移植术治疗109例肾性继发性甲状旁腺功能亢进的长期疗效[J]. 山东大学学报 (医学版), 2023, 61(4): 42-48. |
| [12] | 杨晓斐,韩波,姜殿东,吕建利,伊迎春,张建军,赵立健,王静,王艳,袁辉. 经导管射频消融术治疗儿童快速性心律失常972例临床分析[J]. 山东大学学报 (医学版), 2023, 61(2): 49-56. |
| [13] | 马臣帮,高沛,常耀,毛昌琳,陈峰,朱可嘉,管勇,李善军,丁森泰. 非结节性硬化症双肾巨大血管平滑肌脂肪瘤精准诊断及同期两侧手术治疗1例及文献复习[J]. 山东大学学报 (医学版), 2023, 61(2): 65-71. |
| [14] | 王成,张淑卉,闫娜,孟林林,陈良志,刘庆华. 脐带间充质干细胞治疗中晚期博来霉素诱导小鼠肺间质纤维化的机制[J]. 山东大学学报 (医学版), 2023, 61(10): 17-22. |
| [15] | 曾彦平,闫圣涛,刘小瑜,江子晴. 以甲状旁腺危象为首发表现的甲状旁腺癌1例文献报道[J]. 山东大学学报 (医学版), 2023, 61(1): 62-68. |
|
||