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首页> 外文会议>Photonic Therapeutics and Diagnostics III; Progress in Biomedical Optics and Imaging; vol.8 no.1; Proceedings of SPIE-The International Society for Optical Engineering; vol.6424 >Robot Assisted Radical Prostatectomy: Histopathologic and Biochemical Recurrence Data at One-Year Follow-Up
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Robot Assisted Radical Prostatectomy: Histopathologic and Biochemical Recurrence Data at One-Year Follow-Up

机译：机器人辅助根治性前列腺切除术：一年随访的组织病理学和生化复发数据

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Introduction: Robotically assisted laparoscopic radical prostatectomy is a minimally invasive alternative for the treatment of prostate cancer. We report the histopathologic and short term PSA outcomes of 500 robotic prostatectomies. Materials and Methods: Five hundred patients underwent robotic radical prostatectomy. The procedure was performed via a six trocar transperitoneal technique. Prostatectomy specimens were analyzed for TNM Stage, Gleason's grade, tumor location, volume, specimen weight, seminal vesicle involvement and margin status. A positive margin was reported if cancer cells were found at the inked specimen margin. PSA data was collected every three months for the first year, then every six months for a year, then yearly. Results: Average pre-operative PSA was 6.9 (1-90) with Gleason's score of 5 (2%), 6 (52%), 7 (40%), 8 (4%), 9(2%). Post operatively histopathologic analysis showed Gleason's 6 (44%), 7(42%), 8(10%), 9(4%). 10%, 5%, 63%, 15%, 5% and 2% had pathologic stage T2a, T2b, T2c, T3a, T3b and T4 respectively. Positive margin rate was 9.4% for the entire series. The positive margin rate per 100 cases was: 13% (1-100), 8% (101-200), 13% (201-300), 5% (301-400) and 8% (401-500). By stage it was 2%, 4%, 2.5% for T2a, T2b, T2c tumors, 23% (T3a), 46% (T3b) and 53% (T4a). For organ confined disease (T2) the margin rate was 2.5% and 31% for non organ confined disease. There were a total of 47 positive margins, 26 (56%) posterolateral, 4 (8.5%) apical, 4 (8.5%) bladder neck, 2 (4%) seminal vesicle and 11 (23%) multifocally. Ninety five percent of patients (n=500) have undetectable PSA ( ＜ 0.1) at average follow up of 9.7 months. Recurrence has only been seen with non organ confined tumors. Those patients with a minimum follow up of 1 year (average 15.7 months) 95% have undetectable PSA ( ＜ 1). Conclusion: Our initial experience with robotic radical prostatectomy is promising. Histopathologic outcomes are acceptable with a low overall margin positive rate. Short term biochemical recurrence free survival has also been good. We believe that the precise dissection allowed by the advantages of laparoscopic robotic surgery will translate into excellent long term oncologic outcomes.
机译：简介：机器人辅助的腹腔镜前列腺癌根治术是治疗前列腺癌的微创替代方案。我们报告了500例机器人前列腺切除术的组织病理学和短期PSA结果。材料和方法：500例患者接受了机器人根治性前列腺切除术。该过程通过六针穿刺腹膜技术进行。分析前列腺切除术标本的TNM分期，格里森氏分级，肿瘤位置，体积，标本重量，精囊囊肿累及边缘状态。如果在着墨的样本边缘发现癌细胞，则报告为阳性边缘。第一年每三个月收集一次PSA数据，一年后每六个月收集一次，然后每年收集一次。结果：术前平均PSA为6.9（1-90），格里森得分分别为5（2％），6（52％），7（40％），8（4％），9（2％）。术后组织病理学分析显示格里森氏6（44％），7（42％），8（10％），9（4％）。病理分期T2a，T2b，T2c，T3a，T3b和T4分别为10％，5％，63％，15％，5％和2％。整个系列的正边际利润率为9.4％。每100例病例的阳性毛利率为：13％（1-100），8％（101-200），13％（201-300），5％（301-400）和8％（401-500）。按阶段划分，T2a，T2b，T2c肿瘤分别为2％，4％，2.5％，23％（T3a），46％（T3b）和53％（T4a）。对于器官限定疾病（T2），保证金率为2.5％，非器官限定疾病的保证金率为31％。共有47个阳性切缘，26个（56％）后外侧，4个（8.5％）顶尖，4个（8.5％）膀胱颈，2个（4％）精囊和11个（23％）多灶性。 95％（n = 500）的患者平均随访9.7个月，未发现PSA（＜0.1）。仅在非器官局限性肿瘤中可见复发。至少随访1年（平均15.7个月）的患者中有95％的患者检测不到PSA（＜1）。结论：我们在机器人根治性前列腺切除术方面的初步经验很有希望。组织病理学结果可接受，总体边缘阳性率低。短期生化无复发生存期也很好。我们相信，腹腔镜机器人手术的优势所允许的精确解剖将转化为出色的长期肿瘤学成果。

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