RARP in high-risk prostate cancer：use of multi-parametric MRI and nerve sparing techniques

• 来源期刊: 亚洲男性学杂志（英文版）
• 年，卷（期）: 2014,（9）
• 所属期刊栏目: ORIGINAL ARTICLE
• 页码范围: 715-719
• 页数: 5页
• 语种: 英文
• DOI: 10.4103/1008-682X.129942

摘要

To examine the outcomes of patients with high?risk prostate cancer(PCa) treated by robot?assisted radical prostatectomy(RARP) and evaluate the value of multi?parametric magnetic resonance imaging(MRI) in estimating tumor stage, extracapsular extension, and grade, and the application of nerve sparing(NS) techniques. Patient demographics, preoperative imaging, surgical parameters, pathological features, functional and recurrence outcomes were collected retrospectively in patients with high?risk PCa who underwent RARP between December 2009 and October 2013. Pathological whole mount slides to assess NS were compared with potency, recovery of continence, and surgical margins(SM). Forty?four cases of high?risk PCa were identiifed with a median followup of 24months and positive surgical margins(PSM) rate of 14%. Continence returned in 86%, with potency rate of 58%. Of the 25cases with a preoperative multi?parametric MRI, MRI improved clinical staging from 28% to 88%, respectively. Following risk stratiifcation of NS by microscopic analysis of whole mount pathology, patients with GroupA(bilateral NS), GroupB (unilateral NS), GroupC(partial NS), and GroupD(non?NS) had 100%, 92%, 91%, and 50% continence rates, and 100%, 80%, 45%, and 0%potency rates, respectively, with an inverse correlation to PSM. RARP in men with high?risk PCa can achieve favorable oncologic and functional outcomes. Preoperative MRI may localize high?grade tumors and improve clinical staging. Extent of NS is inlfuenced by clinical staging and may balance potency and continence with PSMs.