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IF 0.6 4区医学 Q4 UROLOGY & NEPHROLOGY

Archivos Espanoles De Urologia Pub Date : 2025-03-01 DOI:10.56434/j.arch.esp.urol.20257802.24

Rongrong Meng, Xuefen Wang, Zhengzheng Shi

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引用次数: 0

摘要

目的：约有三分之一的前列腺癌（PCa）患者在接受初次根治性治疗后会出现生化复发（BCR）。BCR 大大增加了远处转移的风险，并与较高的死亡率有关，尤其是预后指标较差的患者。本研究旨在探讨根治性前列腺切除术后手术切缘阳性（PSMs）与BCR之间的密切关系，为预测患者生存率和优化术后干预策略提供基础性见解和指导：对2015年1月至2021年1月期间在宁波鄞州第二医院接受腹腔镜前列腺癌根治术的498例患者的临床数据进行回顾性分析。对病理标本和病历进行了回顾性分析。其中，127例前列腺癌根治术（PSM）患者和279例手术切缘阴性（NSM）患者纳入统计分析。分析纳入了临床和病理参数，包括原发肿瘤特征、PSMs、病理肿瘤分期、手术切缘状态、Gleason分级组和其他相关因素，并以无BCR生存率作为主要终点：在本研究的随访期间，406 名患者中发现了 129 例 BCR。其中，34 例发生在 PSM 患者中，约占 26.8%（34/127）；95 例发生在 NSM 患者中，约占 34.1%（95/279）。两组患者的复发率差异具有统计学意义（P < 0.001）。PSM 患者的 BCR 中位时间为 19.2 个月，而 NSM 患者的 BCR 中位时间为 28.2 个月，这一差异也具有统计学意义（P < 0.001）。与原发肿瘤特征相比，PSM患者的Gleason分级组对复发的预测作用更强：结论：在接受前列腺癌根治术的患者中，PSMs的存在是BCR的重要独立预测因素。早期发现并及时干预PSM患者对改善术后预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Biochemical Recurrence Following Radical Prostatectomy for Prostate Cancer with Positive Surgical Margins.

Objective: Approximately one-third of individuals diagnosed with prostate cancer (PCa) experience biochemical recurrence (BCR) following their initial curative therapy. BCR significantly increases the risk of distant metastases and is associated with higher mortality rates, particularly in patients with poor prognostic indicators. This study aims to investigate the strong correlation between positive surgical margins (PSMs) and BCR after radical prostatectomy, offering foundational insights and guidance for predicting patient survival and optimising postoperative intervention strategies.

Methods: A retrospective analysis was conducted on the clinical data of 498 patients who underwent laparoscopic radical prostatectomy between January 2015 and January 2021 at Ningbo Yinzhou No.2 Hospital. Pathological specimens and medical records were reviewed. Of these, 127 patients with PSMs and 279 patients with negative surgical margins (NSMs) were included in the statistical analysis. The analysis incorporated clinical and pathological parameters, including primary tumour characteristics, PSMs, pathological tumour staging, surgical margin status, Gleason grade group, and other relevant factors, with BCR-free survival as the primary endpoint.

Results: During the follow-up period of this study, 129 cases of BCR were identified among the 406 patients. Of these, 34 cases occurred in patients with PSMs, accounting for approximately 26.8% (34/127), and 95 cases occurred in patients with NSMs, accounting for approximately 34.1% (95/279). The difference in recurrence between the two groups was statistically significant (p < 0.001). The median time to BCR was 19.2 months for patients with PSMs, compared to 28.2 months for patients with NSMs, with this difference also reaching statistical significance (p < 0.001). The Gleason grading group in patients with PSMs was a stronger predictor of recurrence than the primary tumour characteristics.

Conclusions: The presence of PSMs is a significant independent predictor of BCR in patients undergoing radical prostatectomy for PCa. Early detection and timely intervention for patients with PSMs are crucial for improving postoperative outcomes.

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来源期刊

Archivos Espanoles De Urologia UROLOGY & NEPHROLOGY-

CiteScore

0.90

自引率

0.00%

发文量

111

期刊介绍： Archivos Españoles de Urología published since 1944, is an international peer review, susbscription Journal on Urology with original and review articles on different subjets in Urology: oncology, endourology, laparoscopic, andrology, lithiasis, pediatrics , urodynamics,... Case Report are also admitted.