摘要
目的:探讨经脐三臂法机器人辅助根治性前列腺切除术(TTRARP)治疗寡转移性前列腺癌(omPCa)的近期临床效果。方法:选取2020年1月—2023年5月在四川省人民医院泌尿外科收治的100例omPCa患者,根据治疗方式分为研究组(51例,接受TTRARP手术联合药物治疗)和对照组(49例,接受药物治疗)。比较两组患者前列腺特异性抗原(PSA)水平、并发症发生情况以及无去势抵抗性前列腺癌(CRPC)生存时间。结果:干预1个月后,两组患者PSA水平比较,差异无统计学意义(P>0.05),但研究组PSA平均下降率高于对照组(P<0.05);干预1年后,两组患者PSA水平及平均下降率比较,差异无统计学意义(P>0.05)。研究组累积风险上升速度慢于对照组,总体生存率高于对照组。多因素分析显示,突破前列腺包膜、转移灶数目≥4个及Gleason评分>8分是无CRPC生存时间的独立危险因素。结论:TTRARP可以短期内有效降低PSA水平,延长无CRPC生存期,尤其适用于转移灶<4个、Gleason评分≤8分且未突破包膜的患者,但需关注吻合口瘘风险。
Objective:To investigate the short-term clinical outcomes of transumbilical three-arm robot-assisted radical prostatectomy(TTRARP)for oligometastatic prostate cancer(omPCa).Methods:100 omPCa patients who were treated at Sichuan Provincial People’s Hospital from January 2020 to May 2023 were selected and divided into the study group(n=51,receiving TTRARP surgery combined with drug treatment)and the control group(n=49,receiving drug treatment).Prostate-specific antigen(PSA)levels,complication rates,and castration-resistant prostate cancer-free survival(CRPC-free survival)were compared between the two groups of patients.Results:One month after intervention,there was no statistically significant difference in PSA levels between the two groups(P>0.05),but the average PSA decline rate was higher in the study group than that in the control group(P<0.05).One year after intervention,there was no statistically significant difference in PSA levels or the average decline rates between the two groups(P>0.05).The study group showed slower cumulative risk progression than the control group,and the overall survival rate was higher in the study group than that in the control group.Multivariate analysis identified prostatic capsular penetration,≥4 metastatic lesions,and Gleason score>8 as independent risk factors for shortened CRPCfree survival.Conclusion:TTRARP can effectively reduce PSA levels and prolong CRPC-free survival in the short term,especially for patients with<4 metastases,Gleason score≤8 and intact prostatic capsule,but the risk of anastomotic fistula should be concerned.
作者
刘畅林
刘伯萸
赵婷
张赢予
LIU Changlin;LIU Boyu;ZHAO Ting;ZHANG Yingyu(Department of Comprehensive Surgery,the Second Medical Center/National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China)
出处
《机器人外科学杂志(中英文)》
2025年第7期1122-1127,共6页
Chinese Journal of Robotic Surgery
基金
2017年中国医药教育协会护理项目(药教协(项)字[2017]第001号)。
