Отдаленные результаты позадилонной радикальной простатэктомии и их прогнозирование

Abstract

Radical retropubic prostatectomy is one of the most widely used and highly effective ways of managing of patients with clinically local prostate cancer.Purpose: The purpose of our study is to evaluate long term results of treatment of patients with clinically local and locally advanced prostate cancer and to define prognostic factors.Materials and methods: 332 patients with prostate cancer who underwent radical retropubic prostatectomy were followed up. Mean follow up time was 53,85±30,39 months. Local prostate cancer (pT2 disease) was found in 61,0% of patients, locally advanced (pT3) and advanced (pT4) stages of disease was registered in 39,0%. Finally, in 6,0% of patients involvement of regional lymph nodes was diagnosed.Results: overall 5 and 7-year survival rates after radical retropubic prostatectomy were 89,85±2,02 and 89,1±2,14%, respectively; adjusted survival rates were identical (94,76±1,58%); disease free survivals were 62,38±3,18 and 44,03±3,67%, respectively. Relapses of prostate adenocarcinomas clearly correlate with preoperative serum level of prostate specific antigen and such pathologic signs as tumor differentiation grade and extent of disease (р≤0,05). Correlation of long term outcomes with results of digital rectal investigation of prostate gland, positive resection lines and lymph node involvement is less evident, but nonetheless statistically significant (р≤0,05).Conclusions: radical retropubic prostatectomy is highly effective treatment modality for patients with local prostate cancer and for selected patients with locally advanced diseases. Determining the prognostic significance of various factors provides a mean to sort out patients at increased risk of disease relapse. This subset of patient needs close follow up to timely diagnose disease recurrence and adjust therapy, therefore improving survival of patients.

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