摘要
前列腺癌是全球男性最常见的恶性肿瘤之一。局部晚期前列腺癌是指肿瘤突破了前列腺包膜,侵犯精囊或邻近组织(T_(3a)-T_4),和/或合并有区域淋巴结转移,没有远处转移的前列腺癌(cT_(3a)-4N_(0-1)M_0)。局部晚期前列腺癌恶性程度高,复发转移率高。过去由于较高的手术切缘阳性率和术后并发症发生率,局部晚期前列腺癌不推荐手术治疗。然而,手术技术的改进及综合内分泌治疗使得这些患者的预后优于局部放疗或放疗联合内分泌治疗。主要针对局部晚期前列腺癌外科治疗的合理性与优势、预后、扩大淋巴结清扫意义及并发症等进行述评。
Prostate cancer is the most common malignancy in men worldwide. Locally advanced prostate cancer is characterized by extracapsular extension( pT_(3a)),invasion of the seminal vesicles( pT_(3b)),invasion of adjacent organs(T_4),and/or positive regional lymph node but no distant metastasis. Locally advanced prostate cancer shows remarkably malignant behavior and a high rate of recurrence and metastasis. In the past,surgical treatment was considered unfavorable for locally advanced prostate cancer due to the high positive surgical margin rates and increased complication rates. However,improvements in surgical techniques and combined endocrine therapy have enabled the outcomes for these patients as compared to local radiotherapy or radiotherapy combined with endocrine therapy. This paper reviews the rationality and advantages,prognosis,extensive lymph node dissection,and complications of surgical treatment in patients with locally advanced prostate cancer.
引文
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