拯救性淋巴结清扫术治疗前列腺癌根治术后淋巴结转移
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摘要
<正>淋巴结转移是导致前列腺癌根治术后生化复发的主要原因。Briganti等~([1])在2006年报道T3b～T4期前列腺癌术后56.7%患者有淋巴结转移,而同期完成的盆腔扩大淋巴结清扫仅完成77%阳性淋巴结的清除。Wilczak等~([2])报道前列腺癌细胞侵犯淋巴管对术后生化复发的影响等同于淋巴结转移。在14 528例完成前列腺癌根治术的病例进行回顾性研究中发现,没有淋巴结转移的患者中有11%发现有淋巴管侵犯;有淋巴结转移的患者中有61%同时伴有淋巴管侵犯。无论是淋巴结转移还是淋巴管侵犯均会对术后生化复发产生显著的影响。
引文
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[2]Wilczak W,Wittmer C,Clauditz T,et al.Marked prognostic impact of minimal lymphatic tumor spread in prostate cancer[J].Eur Urol,2018,74(3):376-386.
[3]Sundi D,Tosoian JJ,Nyame YA,et al.Outcomes of very high-risk prostate cancer after radical prostatectomy:Validation study from3 centers[M].Cancer,2018.
[4]Grosu AL,Weirich G,Wendl C,et al.11C-Choline PET/pathology image coregistration in primary localized prostate cancer[J].Eur JNucl Med Mol Imaging,2014,41(12):2242-2248.
[5]Abreu A,Fay C,Park D,et al.Robotic salvage retroperitoneal and pelvic lymph node dissection for'node-only'recurrent prostate cancer:technique and initial series[J].BJU Int,2017,120(3):401-408.
[6]Winter A,Henke RP,Wawrosche kF.Targeted salvage lymphadenectomy in patients treated with radical prostatectomy with biochemical recurrence:complete biochemical response without adjuvant therapy in patients with low volume lymph node recurrence over a long-term follow-up[J].BMC Urol.2015,15:10.
[7]Kaplan AL,Hu JC,Morgentaler A,et al.Testosterone therapy in men with prostate cancer[J].Eur Urol,2016,69(5):894-903.
[8]Maurer T,Robu S,Schottelius M,et al.99mTechnetium-based prostate-specific membrane antigen-radioguided surgery in recurrent prostate cancer[J].Eur Urol.2018,pii:S0302-2838(18)30189-1.
[9]Manny TB,Patel M,Hemal AK.Fluorescence-enhanced robotic radical prostatectomy using real-time lymphangiography and tissue marking with percutaneous injection of unconjugated indocyanine green:the initial clinical experience in 50 patients[J].Eur Urol,2014,65(6):1162-1168.