Our Experience with Radical Prostatectomy and Extended Pelvic Lymph Node Dissection in the Treatment of Clinical Stage T3 Prostate Cancer and Its Possible Advantages

I. Kartal, O. Alkış, Mehmet Sevim, O. Sönmez, Serkan Telli, B. Aras
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Abstract

Our experience with radical prostatectomy and extended pelvic lymph node dissection in the treatment of clinical T3 and its possible advantages. Abstract Objective: To evaluate the impact of radical prostatectomy (RP) and extended pelvic lymph node dissection (EPLND) on the disease process in terms of oncological outcomes and quality of life in the treatment of clinical stage cT3N0M0 prostate cancer (PCa). Materials and Methods: The data of patients with cT3N0M0 who had undergone open radical prostatectomy and extended pelvic lymph node dissection in our clinic between January 2015 and March 2021 were analyzed retrospectively. Preoperative and postoperative data were compared in terms of oncological and functional outcomes. Biochemical recurrence was accepted as detection of PSA >0.2 ng/ml on consecutive measurements and biochemical disease-free survival time was calculated. Results: The mean age of 23 operated patients who met the study criteria, was 66.8±7.4 years. In the pathological staging, the organ-confined disease was detected in 10 (43.4%) patients. Surgical margin positivity was observed in 6 (26.2%), while lymph node positivity in 3 (13.1%) patients. Biochemical recurrence was detected in 7 (30.2%) patients during a mean follow-up period of 33.6±22.9 months. The mean biochemical disease-free survival time was 48.4±6.3 months. In the evaluations of the patients at the postoperative 6 th months, a 3.2±2.2-point decrease was found in the International Prostate Symptom Score (IPSS) (p=0.001) and a 13.1±5.0 point decrease in the International Index of Erectile Function (IIEF) score (p=<0.001). Conclusion: Radical prostatectomy and extended pelvic lymph node dissection applied in the treatment of locally advanced prostate cancer is seem to be an effective and safe treatment method in terms of oncological and functional outcomes.
根治性前列腺切除术和扩大盆腔淋巴结清扫术治疗临床T3期前列腺癌的经验及其可能的优势
我们在根治性前列腺切除术和扩大盆腔淋巴结清扫治疗临床T3的经验及其可能的优势。摘要目的:探讨根治性前列腺切除术(RP)联合盆腔淋巴结清扫术(EPLND)对临床分期cT3N0M0期前列腺癌(PCa)患者肿瘤预后及生活质量的影响。材料与方法:回顾性分析我院2015年1月至2021年3月行开放性根治性前列腺切除术及扩大盆腔淋巴结清扫术的cT3N0M0患者资料。术前和术后的数据比较肿瘤和功能结果。连续测定PSA >0.2 ng/ml为生化复发,计算生化无病生存时间。结果:23例符合研究标准的手术患者平均年龄为66.8±7.4岁。病理分期中,器官局限性病变10例(43.4%)。手术缘阳性6例(26.2%),淋巴结阳性3例(13.1%)。7例(30.2%)患者在平均33.6±22.9个月的随访中出现生化复发。平均生化无病生存时间为48.4±6.3个月。术后6个月对患者的评价中,国际前列腺症状评分(IPSS)下降3.2±2.2分(p=0.001),国际勃起功能指数(IIEF)评分下降13.1±5.0分(p=<0.001)。结论:根治性前列腺切除术联合盆腔淋巴结清扫术治疗局部晚期前列腺癌是一种安全有效的治疗方法。
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