Eur Urol:比较开放耻骨后与机器人辅助根治性前列腺切除术后的勃起功能与肿瘤预后。

2017-09-14 fengxiangxin MedSci原创

为了比较不同癌症分期的患者接受不同前列腺癌手术方法(开放性手术or机器人辅助腹腔镜技术)后勃起功能的恢复以及肿瘤的预后,研究者开展了一项前瞻性非随机对照试验。他们分别从7个开放性手术中心(n=753)和7个机器人辅助手术中心(n=1792)一共招募了2545位前列腺癌患者。

为了比较不同癌症分期的患者接受不同前列腺癌手术方法(开放性手术or机器人辅助腹腔镜技术)后勃起功能的恢复以及肿瘤的预后,研究者开展了一项前瞻性非随机对照试验。他们分别从7个开放性手术中心(n=753)和7个机器人辅助手术中心(n=1792)一共招募了2545位前列腺癌患者。

研究者收集了基于问卷的患者报告,统计患者术前和术后3个月、12个月和24个月的勃起功能情况,并记录了手术报告的神经血管束保留程度、病理学报道的阳性切缘率和术后两年PSA复发率。

在术前勃起功能较好的1702位患者中,研究者发现在机器人辅助手术组中,低/中风险的患者术后3个月时勃起功能恢复增强了。对于肿瘤风险较高的患者,术后24个月时勃起功能恢复程度更加倾向于开放手术。在机器人辅助手术中,神经血管束的保留程度体现出了与勃起功能恢复更加密切的相关性。

在肿瘤分级为pT2的患者中,开放手术和机器人辅助手术的阳性切缘率分别为10%和17%;肿瘤分级为pT3的患者中,分别为48%和33%。在肿瘤分级为pT3的患者中,上述差异与肿瘤的生化复发相关,但在肿瘤分级为pT2的患者中无相关性。

最终,在两者的角逐中,机器人辅助手术在低风险患者中较早的勃起功能恢复的优势被开放性手术在局限性肿瘤中较低的阳性切缘率所抵消。同时,在肿瘤分级为pT3的患者根治性前列腺切除术中,机器人辅助手术能更容易的识别出神经保留水平。

原始出处:


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    2018-03-23 habb
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channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61204, encryptionId=6a446120454, topicName=机器人辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=324410545094, createdName=124987a0m69(暂无昵称), createdTime=Sat Sep 16 03:12:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583061, encodeId=e5791583061ed, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Sat Sep 16 03:12:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586069, 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time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243944, encodeId=ccaf243944a4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 14 13:07:17 CST 2017, time=2017-09-14, status=1, ipAttribution=)]
    2017-09-16 xue8602
  5. 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time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243944, encodeId=ccaf243944a4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 14 13:07:17 CST 2017, time=2017-09-14, status=1, ipAttribution=)]
  6. 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  7. 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time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243944, encodeId=ccaf243944a4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 14 13:07:17 CST 2017, time=2017-09-14, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1708826, encodeId=77161e0882678, content=<a href='/topic/show?id=ffca32501e6' target=_blank style='color:#2F92EE;'>#前列腺切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32501, encryptionId=ffca32501e6, topicName=前列腺切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Apr 23 12:12:00 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771137, encodeId=58c61e71137d4, content=<a href='/topic/show?id=c1c6334227d' target=_blank style='color:#2F92EE;'>#勃起#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33422, encryptionId=c1c6334227d, topicName=勃起)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78b838213583, 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encodeId=4f2d1586069da, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Sat Sep 16 03:12:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244027, encodeId=323624402e73, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Sep 14 20:24:49 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243944, encodeId=ccaf243944a4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 14 13:07:17 CST 2017, time=2017-09-14, status=1, ipAttribution=)]
    2017-09-16 jeanqiuqiu
  9. [GetPortalCommentsPageByObjectIdResponse(id=1708826, encodeId=77161e0882678, content=<a href='/topic/show?id=ffca32501e6' target=_blank style='color:#2F92EE;'>#前列腺切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32501, encryptionId=ffca32501e6, topicName=前列腺切除)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Apr 23 12:12:00 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771137, encodeId=58c61e71137d4, content=<a href='/topic/show?id=c1c6334227d' target=_blank style='color:#2F92EE;'>#勃起#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33422, encryptionId=c1c6334227d, topicName=勃起)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78b838213583, 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encodeId=4f2d1586069da, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Sat Sep 16 03:12:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244027, encodeId=323624402e73, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Sep 14 20:24:49 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243944, encodeId=ccaf243944a4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 14 13:07:17 CST 2017, time=2017-09-14, status=1, ipAttribution=)]
    2017-09-14 天涯183

    非常好的文章.学习了

    0

  10. 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encodeId=4f2d1586069da, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Sat Sep 16 03:12:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244027, encodeId=323624402e73, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Sep 14 20:24:49 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243944, encodeId=ccaf243944a4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Sep 14 13:07:17 CST 2017, time=2017-09-14, status=1, ipAttribution=)]
    2017-09-14 Y—xianghai

    学习了新知识

    0

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肿瘤细胞与疾病进展有关,会影响治疗敏感度。循环肿瘤细胞(CTC)被认为是远处转移的种子。循环肿瘤细胞的存在使得通过简单的血标本检测肿瘤组织信息成为可能。CLIN CANCER RES近期发表了一篇文章,研究不同循环肿瘤细胞亚型及其他细胞在前列腺癌中发挥的预后作用。

J Surg Oncol:根治性前列腺切除术后尿失禁修复术的全国性的和基于人群的研究

最近,有研究人员进行了旨在评估根治性前列腺切除术(RP)后尿失禁(PPI)手术的使用情况和调查了该手术使用相关的因素。群体研究是在瑞典男性前列腺癌数据库(PCBaSe)中进行的,这些病人是在1998年和2012年年间进行初次的RP。PPI修正术过程在病人注册处进行鉴定。另外,研究人员还评估了PPI外科手术的风险比(HR)和95%的置信区间(CIs)。研究发现,26280名男性中的782名(3%)男

Sci Rep:前列腺癌细胞中线粒体代谢对阿霉素响应的调查

前列腺癌(PCa)在美国是男性中主导的癌症之一。预测治疗反应实验工具的缺乏是目前治疗方案限制之一。线粒体功能的异常包括癌症中氧化磷酸化的缺失(OXPHOS),通过雕刻ROS的产生和细胞学信号抑制了细胞凋亡。因此,线粒体功能异常的修复和细胞凋亡的诱导在癌症治疗中是非常有希望的策略。最近,有研究人员利用荧光生命期成像显微镜(FLIM),通过追踪自发荧光的NAD(P)H、FAD和色氨酸(Trp)生命期和

Mol Cancer:长非编码RNA ZEB1-AS1可表观调控ZEB1和下游分子的表达

越来越多的研究表明长非编码RNAs(lncRNAs)在肿瘤形成和癌症恶化中起着重要作用。来源于ZEB1启动子区域的lncRNA ZEB1 反义1(ZEB1-AS1)到现在为止,人们对其表达、作用和机制所知甚少。最近,有研究人员利用RACE技术获得了ZEB1-AS1的序列,并利用RNA干扰技术减少ZEB1-AS1的表达,还利用腺病毒表达载体来增加ZEB1-AS1的表达。另外,研究人员利用CHIP和R

Nat commun:人类前列腺癌恶化和转移的基质和上皮转录图谱

尽管正常前列腺上皮恶化到侵入性癌症是由分子变异驱使的,肿瘤细胞和癌症微环境中的细胞是相互依赖的和共同进化的。到目前为止,很少有研究聚焦基质。最近,有研究人员对激光捕获显微切割的正常非瘤前列腺上皮组织进行了基因表达的分析,并且将该表达数据与从根治性前列腺切除术获得的非转的和瘤的低等级和高等级前列腺上皮组织的表达数据进行了比较,并且每一个样本都带有其周围的基质。研究发现,具有或者不具有肿瘤的前列腺良性

Am J Transl Res:或可通过靶向miR-204/ZEB1治疗晚期/耐药前列腺癌患者

microRNAs (miRNAs)所致的表观基因失活在肿瘤恶性转化、防止凋亡、耐药性和转移中起着至关重要的作用。研究已经发现前列腺癌(PC)中miR-204的表达失调,且认为miR-204与肿瘤耐药性的发生相关。然而,miR-204在PC中发挥作用的详细机制,特别是耐药性,尚未完全阐明。本研究中,研究人员利用miRNA微阵列分析发现,与药物敏感的PC组织及良性前列腺增生组织中相比,耐药PC组织中