在前列腺癌的激进前列腺切除术期间的盆腔淋巴结剖析:危害与益处
Urologia internationalis
|February 2, 2026
概括
在急性前列腺切除术 (RP) 期间的盆腔淋巴结解剖 (PLND) 增加了并发症,但没有改善癌症复发率. PLND主要作为前列腺癌患者的分期手术.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 手术病理学手术病理学
背景情况:
- 进行激进前列腺切除术 (RP) 的前列腺癌患者可能面临区域淋巴结入侵 (LNI) 的风险.
- 盆腔淋巴结解剖 (PLND) 是在RP期间进行的一种程序,用于评估LNI.
- 需要对PLND的瘤益处和潜在危害进行评估.
研究的目的:
- 评估前列腺癌患者在RP期间PLND的危害和瘤益处.
- 评估PLND对术后和瘤结局的影响.
- 为了确定生物化学复发的预后因素.
主要方法:
- 对2013年至2023年期间接受RP的前列腺癌患者的回顾性研究.
- 具有 (n=334) 和没有 (n=161) PLND的患者之间的结局的比较.
- 使用治疗权重的反向概率 (IPTW) 进行调整分析.
主要成果:
- 接受PLND的患者的手术时间更长,并发症率更高 (58.3%与PLND相关).
- 两组之间没有观察到4年生化无复发生存期 (BRFS),无转移生存期或总生存期的显著差异.
- 在IPTW调整后的队列中,PLND没有显著影响BRFS (HR 0.70,p=0.09).
结论:
- 在RP期间的PLND增加了术后并发症.
- PLND并不能改善前列腺癌的短期瘤结果.
- PLND主要作为指导管理决策的分阶段程序.
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