简介：

简介：AbstractBackground:Various prediction tools have been developed to predict biochemical recurrence (BCR) after radical prostatectomy (RP); however, few of the previous prediction tools used serum prostate-specific antigen (PSA) nadir after RP and maximum tumor diameter (MTD) at the same time. In this study, a nomogram incorporating MTD and PSA nadir was developed to predict BCR-free survival (BCRFS).Methods:A total of 337 patients who underwent RP between January 2010 and March 2017 were retrospectively enrolled in this study. The maximum diameter of the index lesion was measured on magnetic resonance imaging (MRI). Cox regression analysis was performed to evaluate independent predictors of BCR. A nomogram was subsequently developed for the prediction of BCRFS at 3 and 5 years after RP. Time-dependent receiver operating characteristic (ROC) curve and decision curve analyses were performed to identify the advantage of the new nomogram in comparison with the cancer of the prostate risk assessment post-surgical (CAPRA-S) score.Results:A novel nomogram was developed to predict BCR by including PSA nadir, MTD, Gleason score, surgical margin (SM), and seminal vesicle invasion (SVI), considering these variables were significantly associated with BCR in both univariate and multivariate analyses (P < 0.05). In addition, a basic model including Gleason score, SM, and SVI was developed and used as a control to assess the incremental predictive power of the new model. The concordance index of our model was slightly higher than CAPRA-S model (0.76 vs. 0.70, P = 0.02) and it was significantly higher than that of the basic model (0.76 vs. 0.66, P = 0.001). Time-dependent ROC curve and decision curve analyses also demonstrated the advantages of the new nomogram.Conclusions:PSA nadir after RP and MTD based on MRI before surgery are independent predictors of BCR. By incorporating PSA nadir and MTD into the conventional predictive model, our newly developed nomogram significantly improved the accuracy in predicting BCRFS after RP.

简介：通常，组织缺氧是在松驰的阴茎的一个正常生理的条件，被常规夜的勃起在cavernosal织物的坚持的组织缺氧由于neuropraxia结果在激进的前列腺切除术以后与自发、夜的勃起的正常可勃起的function.1缺乏在男人打断，它导致cavernosal的apoptosis和退化光滑的肌肉纤维。因此，克服组织缺氧被相信在neuropraxia期间起一个关键作用。真空的使用在阴茎康复的可勃起的设备(VED)据说是有效的并且可以阻止阴茎长度的损失。在VED使用以后的肉体的血被增加并且由动脉、静脉的血组成，由颜色Dopplersonography和血气体分析揭示了。类似的现象在否定压力创伤治疗(NPWT)被观察。然而，NPWT比VED，和hypoperfused采用一个更低的否定压力地区，响应邻近创伤边的否定压力增加，被观察。尽管如此，询问考虑理想的低于大气层的压力层次，行动的模式，和VED的治疗学的持续时间仍然保持未答复。而且，一个hypoperfused地区或PO2坡度是否在VED期间出现在阴茎，仍然保持不清楚治疗。在阴茎康复优化一个临床的VED协议，关于VED的机制的进一步的研究，在阴茎的不同部分的特别即时的PO2大小，应该被执行。

简介：无

简介：我们在经历了激进的前列腺切除术(RP)的病人之中根据前列腺癌症的clinicopathological特征调查了瘤参与(PTI)的百分比的预示的意义。没有任何neoadjuvant或辅助治疗，经历了在2003年9月和2008年3月之间的RP的534个病人的回顾的研究被执行。有各种各样的clinicopathological特征和生物化学的没有复发的幸存的PTI的协会经由uni-和multivariate分析被检验。multivariate模型的预兆的精确性与在曲线下面操作导出特征的区域的接收装置被估计。PTI被表明显著地与外科手术前的前列腺特定的抗原(PSA)被联系水平(P=0.001)，病理学的格利森分数(P<；0.001)，extraprostatic瘤扩展(P<；0.001)，精囊侵略(P<；0.001)并且积极外科的边缘(P<；0.001)在univariate分析。当病人们被成层进疾病风险组时，PTI在低风险的组(P=0.033)然而并非中介之中仅仅是在multivariate分析的生物化学的没有复发的幸存的一个独立预言者--(P=0.287)或高风险的组(P=0.828)。PTI的增加显著地没增加分别地在彻底的病人(P=0.459)和低风险的组(P=0.268)之中为生物化学的没有复发的幸存的预言设计的multivariate模型的精确性。在结论，尽管PTI看起来比在有更高的风险疾病的那些之中是在有低风险的疾病的病人之中的一个更重要的预示的因素，总的来说，PTI不能提供在罐头已经经由确定的预示的因素被获得的以外的另外的预示的信息。

简介：

简介：活跃监视是在有低风险的前列腺癌症的人的一种可接受的治疗选择。在现在的学习，我们回顾地考察了为活跃监视适合标准，但是选择了激进的前列腺切除术的509个人的结果。然后，在upstaging的风险上改变前列腺特定的抗原(PSA)层次并且在这些病人升级的影响被估计。在三活跃监视criteria—下面完成了包括标准的病人的病理学的特征；那些公民加利福尼亚圣弗朗西斯科的大学癌症研究所和Urology—的欧洲协会；被检验。被认为的人的比例活跃监视的候选人但是随后upstaged或升级被决定。509个病人，186(36.5%；)，132(25.9%；)并且88(17.3%；)人们分别地完成了活跃监视标准。(格利森分数7-10)升级从32.8%；到38.6%；，当时upstaging(≥；pT3)从10.2%；到12.5%；，取决于三个活跃监视标准。在24个月的中部的后续以后，三个病人开发了生物化学的复发。当改变PSA层次的影响为每个协议在PSA的上下文为趋势分析用测试被检验时，upstaging的率在有PSA<的人是更低的；4 ；ngml−1。然而，没有在升级上改变PSA层次的影响。在结论，通常使用活跃监视协议带升级和upstaging的风险。更可靠、精确的标记被需要更好成层是活跃监视的适当候选人的人的风险。

简介：这研究的目的是在为前列腺癌症经历了激进的前列腺切除术(RP)的人关于瘤攻击性调查耐心的年龄的预示的意义。在这研究，我们考察了没有neoadjuvant或辅助治疗，在我们的机构收到了RP并且被跟随在上面的743个病人的记录为>；2年手术后地。为我们的分析，病人根据年龄被划分成二个组：更年轻(<；60年)并且更旧(≥；60年)。通过uni-和multivariate分析，包括生物化学的没有复发的幸存，与耐心的年龄，各种各样的clinicopathological参数的协会在所有病人之中被评估，并且病人根据他们的D'Amico风险分类被成层。在所有题目之中，更年轻(n=126)并且更旧(n=617)病人们没关于病理学的参数和生物化学的没有复发的幸存(P=0.288)显示出重要差别。为高风险的组(n=206)，更年轻的病人比更老的病人(P=0.017)有生物化学的没有复发的幸存追随者外科的更低的率，尽管没有重要差别关于在二个年龄组之间的各种各样的已知的预示的参数被观察。另外，multivariate分析表明年龄是在高风险的组(P=0.003)之中的生物化学的没有复发的幸存的一个独立预言者。我们的结果证明相对更年轻的病人与他们后面的RP为前列腺癌症执行了的更旧的对应物相比有可比较的生物化学的结果。在有高风险的疾病的病人之中，然而，更年轻的病人与更老的病人相比有更坏的生物化学的结果追随者RP。

简介：

简介：几种技术被介绍了改进早手术后的克制。在这研究，我们评估了膀胱颈(vesicourethral吻合)的影响extraperitoneal的结果上的暂停内视镜的激进的前列腺切除术(EERPE)。在这研究，180个病人的一个总数经历了EERPE。组织经历了神经圆材EERPE(nsEERPE)(n=45)的1个包括的病人，并且组织与膀胱颈暂停经历了nsEERPE的2个包括的病人(BNS，n=45)。组织3(n=45)并且(n=45)4包括了分别地与BNS收到了EERPE和EERPE的病人。病人们随机被分配与他们的nsEERPE或EERPE过程收到BNS。Perioperative参数被记录，并且克制被在导管移动以后在第二天决定吸收剂垫(垫称测试)的数字和重量并且由一张问询表评估3个月手术后地。在导管移动以后的二天，11.1%；组1，11.1%；组2，4.4%；组3和8.9%；组4者之中是大陆。平均的尿损失是80.4，70.1，325.0和291.3 ；为这些的各个的g分别地组织。在3个月，76.5%；组1和81.3%；组2者之中是大陆。为组3和4的克制数字是48.5%；并且43.8%；分别地。类似的全面的率在所有组被观察。在结论，尽管在文学有争论报告，当时，早克制从来没被观察在BNS组显著地更高与non-BNS组相比，不管EERPE，技术表现了。

简介：AbstractBackground:The role of local treatment in oligometastatic prostate cancer (PCa) is gaining interest with the oligometastases hypothesis proposed and the improvement of various surgical methods and techniques. This study aimed to compare the short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy (RALP) for oligometastatic prostate cancer (OPC) vs. localized PCa using propensity score matching.Methods:Totally 508 consecutive patients underwent RALP as a first-line treatment. The patients were divided into two groups according to oligometastatic state: the OPC group (n = 41) or the localized PCa group (n = 467). Oligometastatic disease was defined as the presence of two or fewer suspicious lesions. The association between the oligometastatic state and therapeutic outcomes of RALP was evaluated, including biochemical recurrence (BCR) and overall survival (OS). A Cox proportional hazards model was used to assess the possible risk factors for BCR.Results:Totally 41 pairs of patients were matched. The median operative time, the median blood loss, the overall positive surgical margin rate, the median post-operative hospital stays, and the post-operative urinary continence recovery rate between the two groups showed no statistical significance. The 4-year BCR survival rates of the OPC group and localized PCa group were 56.7% and 60.8%, respectively, without a significant difference (P= 0.804). The 5-year OS rates were 96.3% and 100%, respectively (P = 0.326). Additionally, the results of Cox regression showed that oligometastatic state was not an independent risk factor for BCR (P = 0.682).Conclusions:Our findings supported the safety and effectiveness of RALP in OPC. Additionally, oligometastatic state and sites did not have an adverse effect on BCR independently.

简介：Objective:Prostatecancers(PCa)inAsianindividualsaremolecularlydistinctfromthosefoundintheirCaucasiancounterparts.ThereisnoriskstratificationtoolforAsianmenwithrapidbiochemicalrecurrence(BCR)followingradicalprostatectomy(RadP).Thisstudyaimstoassessthedetectionrateof^68Ga-prostate-specificmembraneantigen-positronemissiontomography/computedtomography(PSMA-PET/CT)fordiagnosisofclinicalrecurrenceandasatreatmentdecisionmakingtoolinAsianpatientswithBCRpost-RadP.Methods:^68GaPSMA-PETandCTbodywith/withoutbonescan[conventionalworkup(CWU)]wereperformedin55AsianpatientswithBCRwithin36monthspost-RadP.Twoblindedreviewersassessedtheimages.Detectionratesof^68GaPSMAPET/CTwereevaluated,andimpactonmanagementwasreviewedbycomparisonwithCWU.Results:MediantimetoBCRpost-RadPwas8.1months.Detectionratefor^68GaPSMA-PET/CTwas80%(44/55).Apositivescanwassignificantlyassociatedwithincreasingprostate-specificantigen(PSA)level[oddsratio(OR)=1.13(95%CI1.05–1.30),P=0.017],butnotwithhigherGleasongradeorshorterPSAdoublingtime.ComparedtoCWU,68GaPSMA-PET/CTdetectedanadditional106lesionsin33/44patientswithapositivescan,resultinginachangeinmanagementin25/44(56.8%)patients:10tohormonaltherapy(HT)andwholepelvisradiotherapy(RT)inadditiontobedRT,and15topalliativeHTalone.Conclusions:Inthepresentreport,wedemonstratedthediagnosticandtreatmentdecisionutilityof^68GaPSMA-PET/CTinAsianmenwithrapidBCR.DetectionofsmallvolumenodalandsystemicrecurrencesatlowPSAlevels(<1.0ng/mL)highlightstheroleofthetoolinassigningpatientstotreatmentintensificationwithHT-RTorpalliativeHTinpolymetastaticdisease.

简介：我们与高风险的前列腺癌症在271个病人报导全面的率，地点和积极外科的边缘(PSM)的预兆的因素。在2008年4月和2011年10月之间，我们有希望地从作为D'Amico分类的病人收集了数据高风险经历了帮助机器人的laparoscopic激进分子前列腺切除术。PSM的全面的率和地点被报导。逐步的逻辑回归模型被适合估计PSM的预兆的因素。PSM的全面的率是25.1%(271个病人中的68个)。这些PSM，(68中的26个)38.2%是posterolateral(PL)，26.5%(68中的18个)multifocal，16.2%(68中的11个)在顶，14.7%(68中的10个)在膀胱颈，并且4.4%(3/68)在另外的地点。有病理学的阶段pT2的病人的PSM率是8.6%(140中的12个)，26.6%(64中的17个)pT3a，53.3%(32/60)pT4的pT3b，和100%(7中的7个)。在包括pre-，intra-，和手术后的参数的一个逻辑回归模型，身体团索引(机会比率[或]：1.09；95%信心间隔[CI]：1.01-1.19，P=0.029)，病理学的舞台(pT3b或更高对pT2；或：5.14；95%CI：1.92-13.78；P=0.001)并且肿瘤的百分比(或：46.71；95%CI：6.37-342.57；P<0.001)是为PSM的独立预兆的因素。在病人在的PSM的最普通的地点高风险是PL方面，它反映报导肿瘤攻击性。PSM的唯一的重要预兆的因素是病理学的结果，例如在标本和病理学的舞台的肿瘤的百分比。

简介：AbstractBackground:Till date, the optimal treatment strategy for delivering adjuvant androgen deprivation therapy (ADT) in localized and locally advanced prostate cancer (PCa), as a lower stage in PCa progression compared with metastatic PCa, is still unclear. This study compares the efficacy of castration alone with complete androgen blockade (CAB) as adjuvant ADT in patients with localized and locally advanced PCa undergoing radical prostatectomy (RP).Methods:Patients diagnosed with PCa, without lymph node or distant metastasis, who received RP in West China Hospital between January 2009 and April 2019, were enrolled in this study. We performed survival, multivariable Cox proportional hazard regression, and subgroup analyses.Results:A total of 262 patients were enrolled, including 107 patients who received castration alone and 155 patients who received CAB. The survival analysis revealed that there was no significant difference between the two groups (hazard ratios [HR]=1.07, 95% confidence intervals [95% CI]=0.60-1.90, P=0.8195). Moreover, the multivariable Cox model provided similarly negative results before and after adjustment for potential covariant. Similarly, there was no significant difference in the clinical recurrence between the two groups in both non-adjusted and adjusted models. Furthermore, our subgroup analysis showed that CAB achieved better biochemical recurrence (BCR) outcomes than medical castration alone as adjuvant ADT for locally advanced PCa (P for interaction=0.0247, HR=0.37, 95% CI=0.14-1.00, P=0.0497).Conclusion:Combined androgen blockade achieved better BCR outcomes compared with medical castration alone as adjuvant ADT for locally advanced PCa without lymph node metastasis.

简介：为在激进的前列腺切除术以后的高风险的局部性的前列腺癌症的辅助神经质的治疗和优化政体的角色仍然保持争论。此处，临床的试用CU1005有希望地评估了最大的雄激素阻塞或bicalutamide的二政体象为高风险的局部性的前列腺癌症的立即的辅助治疗每日的150mg。总的来说，而102收到了9月辅助bicalutamide，209个连续病人在这研究，其中107收到了9月辅助最大的雄激素阻塞，被招募150mg。中部的手术后的后续时间是27.0个月。主要端点是生物化学的复发。209个病人，59个病人开发了生物化学的复发。关于临床的特征的二个组之间没有差别，包括年龄，预告的处理前列腺特定的抗原，格利森分数，外科的边缘地位，或病理学的阶段。最大的雄激素阻塞组经历了更长生物化学的没有复发的幸存(P=0.004)与bicalutamide相比150mg组。在二个组的副作用是类似的并且能中等在所有病人被容忍。在结论，立即的、9月的最大的雄激素阻塞应该作为辅助治疗作为bicalutamide的一种选择被认为150mg为在激进的前列腺切除术以后的高风险的局部性的前列腺癌症病人。

简介：在激进的前列腺切除术(RP)或外部横梁放射治疗(EBRT)以后的健康相关的quality-of-life(HRQOL)没在与疾病风险层化的关系与oncological结果一起被学习。而且，这些治疗途径的长期的结果没被学习。我们回顾地分析了在收到RP的连续病人之间的oncological结果(n=86)并且EBRT(n=76)为局部性的前列腺癌症。HRQOL和功能的结果能在62RP(79%)和54EBRT(79%)被估计在一个3年的后续时期上的病人(中部：41个月)用医药结果学习，短Form-36(SF-36)和加利福尼亚大学洛杉机前列腺癌症索引(UCLA一种总线标准)。5年的生物化学的没有前进的幸存没在RP和EBRT组之间不同为低风险(74.6%对75.0%，P=0.931)并且中间风险(61.3%对71.1%，P=0.691)病人。为高风险的病人，没有前进的幸存比在EBRT组(79.7%)在RP组(45.1%)是更低的(P=0.002)。一般HRQOL在二个组之间是可比较的。关于功能的结果，RP组比EBRT组在尿功能和不太尿的麻烦和性麻烦上报导了更低的分数(P<0.001，P<0.05并且P<0.001，分别地)。与风险层化，在RP组的低风险、中间风险的病人在EBRT组比病人报导了更差的尿功能(P<0.001为各个)。在EBRT组的高风险的病人的性功能比一样的风险RP病人的好(P<0.001)。生物化学的复发没在任何一个组与UCLA一种总线标准分数被联系。在结论，低--可以在长期的后续期间向与RP对待的中间风险的病人汇报相对减少的尿功能。病人在治疗以后的HRQOL没取决于生物化学的复发。