前列腺癌术前新辅助治疗的研究进展

根治性前列腺切除术是治疗局限性前列腺癌的重要方法,但前列腺癌患者术前准确临床分期较困难,常出现肿瘤切除不彻底、术后肿瘤易复发和转移.研究证实术前新辅助内分泌治疗(NHT)能缩小前列腺体积,降低PSA水平,降低手术切缘阳性率,但精囊受侵率及盆腔淋巴结转移无减少,未发现无PSA进展率及肿瘤特异性生存率方面的优势.目前的资料尚不能证实所有患者术前都必须进行新辅助内分泌治疗.

The progress of neoadjuvant hormonal therapy before radical prostatectomy

Radical prostatectomy is an excellent form of treatment of organ-confined prostatic carcinoma. However,the lack of reliable and accurate clinical staging frequently leads to incomplete excision of tumor,with the consequences of early local recurrence or distant metastasis. Randomized trials evaluating the use of neoadjuvant hormonal therapy (NHT).have consistently shown significant decreases in prostate volume and in PSA levels,and cause a significant reduction in the incidence of positive surgical margins,however the incidence of seminal vesicle invasion and metastases to the pelvic lymph nodes does not differ compared to controls. The studies fail to reveal an advantage in terms of PSA progression for treated patients and cancer-specific survival have not been reported yet. Information indicates that NHT before radical prostatectomy should not be considered outside clinical trials.