| Lufang Zhang,Dongliang Pan,Ludong Liu,Yunjiang Zang,Ningchen Li. Salvage treatments for prostate-specific antigen relapse of cT3N0M0 prostatic adenocarcinoma after radical prostatectomy combined with neoadjuvant androgen deprivation. Oncol Transl Med, 2020, 6: 272-276. |
| 根治性前列腺切除术联合新辅助雄激素剥夺治疗cT3N0M0期前列腺癌之后PSA复发的挽救性治疗 |
| Salvage treatments for prostate-specific antigen relapse of cT3N0M0 prostatic adenocarcinoma after radical prostatectomy combined with neoadjuvant androgen deprivation |
| Received:May 04, 2020 Revised:November 23, 2020 |
| DOI：10.1007/s10330-020-0424-4 |
| 中文关键词: 前列腺癌; 根治性前列腺切除术;新辅助雄激素剥夺治疗; 体外放疗; 挽救性治疗; 特异性前列腺抗原复发 |
| 英文关键词: prostatic adenocarcinoma (PCa); radical prostatectomy (RP); neoadjuvant androgen deprivation (ADT); external beam radiation therapy; salvage treatment; prostate specific antigen (PSA) relapse |
| 基金项目: |
| Author Name | Affiliation | Postcode | | Lufang Zhang | Department of Urology, Weifang People’s Hospital | 261000 | | Dongliang Pan* | Department of Urology, Peking University Shougang Hospital | 100144 | | Ludong Liu | Department of Urology, Weifang People’s Hospital | 261000 | | Yunjiang Zang | Department of Urology, Weifang People’s Hospital | 261000 | | Ningchen Li | Department of Urology, Peking University Shougang Hospital | |
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| 中文摘要: |
| 目的：评价cT3N0M0 期前列腺癌行根治性前列腺切除术联合新辅助雄激素剥夺治疗后出现前列腺特异性抗原复发的挽救性治疗效果。 方法： 总共332 例cT3N0M0前列腺癌患者接受三个月的新辅助雄激素剥夺治疗，然后接受了根治性前列腺切除术。所有术后出现前列腺特异性抗原复发的患者采取了挽救性体外放疗和六个月的雄激素剥夺治疗。 结果： 术后5年内出现前列腺特异性抗原复发的患者比例为40.96% (136/332)，所有332例患者分成前列腺特异性抗原（PSA）复发组和PSA无复发组，然后比较两组的患者特征。PSA复发组的Gleason 评分 ≥8和手术切缘阳性的比例高于PSA无复发组。从手术到术后出现PSA复发的平均时间是31个月。对所有136例PSA复发患者采取挽救性治疗之后均达到了较好的控制效果，到随访截止时间，未再出现PSA复发。PSA复发组和PSA无复发组的5年存活率分别是94.9% 和93.9%。 结论： 根治性前列腺切除术联合新辅助雄激素剥夺治疗是积极治疗cT3N0M0 期前列腺癌的治愈性的多方法治疗策略之一，可降低PSA复发、取得较好的存活率。对于术后出现PSA复发的患者采取挽救性体外放疗联合短期的雄激素剥夺治疗依然能取得较好的控制效果。 |
| 英文摘要: |
| Objective: The aim of the study was to evaluate the efficiency of salvage treatments for prostate specific
antigen (PSA) relapse of cT3N0M0 prostatic adenocarcinoma (PCa) after radical prostatectomy (RP)
combined with neoadjuvant androgen deprivation (ADT).
Methods: A total of 332 patients with cT3N0M0 PCa were enrolled in the prospective study and received
RP and pelvic lymph node dissection with neoadjuvant ADT for 3 months. All patients with PSA relapse
were treated with salvage external beam radiation therapy (RT) and ADT for 6 months.
Results: The 5-year postoperative PSA relapse rate was 40.96% (136/332). The patients have been
divided into the PSA relapse and PSA relapse-free groups in order to compare patient characteristics.
The ratio of patients with Gleason score ≥ 8 and positive surgical margin in the PSA relapse group were
significantly higher than those of in the PSA relapse-free group (P = 0.01). The mean duration between the
start of operative treatment and PSA relapse was 31 months. Salvage treatment to all 136 PSA relapse
patients led to favorable outcomes. PSA relapse was not observed after salvage treatment by the end of
follow-up. The 5-year overall survival rates of the PSA relapse and PSA relapse-free groups were 94.9%
and 93.9%, respectively.
Conclusion: In pursuit of curative treatment, our study showed that RP combined with neoadjuvant ADT
is an aggressive multimodality strategy associated with lower PSA relapse and better survival outcomes for
stage cT3N0M0 PCa patients. Patients with PSA relapse after RP may benefit from early aggressive salvage
RT combined with short-term ADT. |
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