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  • 王可屹,毛卫浦,侍 恒,等.大于80岁老年患者前列腺癌根治术随访结果和临床分析[J].同济大学学报(医学版),2020,41(4):473-477.    [点击复制]
  • WANG Ke-yi,MAO Wei-pu,SHI Heng,et al.Radical prostatectomy for locally confined prostate cancer inpatients aged over 80 years[J].同济大学学报(医学版),2020,41(4):473-477.   [点击复制]
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大于80岁老年患者前列腺癌根治术随访结果和临床分析
王可屹,毛卫浦,侍恒,殷雷,王光春,吴宗林,彭波
0
(同济大学附属第十人民医院泌尿外科,上海 200072;东南大学附属中大医院,南京 21000; 同济大学附属普陀人民医院泌尿外科,上海 20006)
摘要:
目的 探讨大于80岁且健康状况良好的前列腺癌老年患者接受前列腺根治术的可行性。方法 回顾性分析了同济大学附属第十人民医院2012年12月—2016年3月的40例80岁及以上前列腺癌患者接受前列腺根治性切除术的相关资料。结果 40例前列腺癌患者年龄为80~86岁,平均(82.30±2.01)岁;血清前列腺特异性抗原为1.2~101.0 ng/mL,平均为(23.59±12.42) ng/mL。查尔森合并症指数(Charlson comorbidity index, CCI)评分,0分35例,1分的5例。cT1N0M0 19例,cT2N0M0 7例,cT3N0M0 14例。Gleason评分<7分9例,Gleason评分为7分24例,Gleason评分>7分7例。手术时间95~156min,平均(122.13±14.57) min。术后随访时间2~36个月,平均(11.03±3.61)个月。尿控恢复时间1~18个月,平均(4.26±1.65)个月。术后有5例接受雄激素剥夺治疗(androgen deprivation therapy, ADT),7例接受ADT同时进行局部外放射疗。术后病理报告1例切缘阳性,尿道狭窄2例。结论 大于80岁且健康状况良好的前列腺癌患者接受前列腺根治术是安全可行的,同时需要在手术获益和手术风险之间进行综合考虑。
关键词:  高龄患者  前列腺根治术  前列腺癌  合并症  安全性
DOI:10.16118/j.1008-0392.2020.04.012
投稿时间:2020-02-11
基金项目:国家自然科学基金(81870517);上海市科学技术委员会科研计划项目(18140900302;19140905402);上海市卫生和计划生育委员会科研课题(20174Y0237)
Radical prostatectomy for locally confined prostate cancer inpatients aged over 80 years
WANG Ke-yi,MAO Wei-pu,SHI Heng,YIN Lei,WANG Guang-chun,WU Zong-lin,PENG Bo
(Dept. of Urology, Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China;;Dept. of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009, China;Dept. of Urology, Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China; Dept. of Urology, Putuo People's Hospital, Tongji University School of Medicine, Shanghai 200060, China)
Abstract:
Objective To investigate the feasibility of radical prostatectomy(RP) for patients aged over 80 years with localized prostate cancer. Methods A retrospective analysis was conducted on 40 patients aged over 80 years with localized prostate cancer who underwent radical prostatectomy in Shanghai Tenth People's Hospital of Tongji University during December 2012 to March 2016. Results The mean age of 40 patients was 82.30±2.01 years(range 80-86), the median serum prostate specific antigen level was (23.59±12.42) ng/mL(range 1.2-101). There were 35 cases with Charlson Comorbidity Index(CCI)=0 and 5 cases with CCI=1, respectively. Of the 40 patients, 19, 7, and 14 had stage cT1N0M0, cT2N0M0, and cT3N0M0, respectively. Gleason scores was 3-6 for 9 cases, 7 for 24 cases, and 8-9 for 7 cases. The median follow-up was 11.03±3.61 months(range 2 to 36). Five patients had androgen deprivation therapy and 7 patients had androgen deprivation therapy with radiotherapy after RP. One patient had positive margin and 2 patients had urethral stricture. Conclusion The radical prostatectomy for patients aged over 80 years with localized prostate cancer in good health is feasible. However, the benefits of surgery should be weighed against the increased risks of surgical complications in this population.
Key words:  elderly patients  radical prostatectomy  prostate cancer  complication  safety

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