International Journal of Urology最新文献_第9页

Trifecta outcomes of robotic partial nephrectomy in obese patients: A comparison of body mass index <25, 25 to <30, and ≥30 肥胖患者机器人肾部分切除术的三重结果：体重指数<25、25-<30和≥30的比较。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-29 DOI: 10.1111/iju.15529

Haruyuki Ohsugi, Junichi Ikeda, Kenta Takayasu, Nae Takizawa, Hisanori Taniguchi, Masaaki Yanishi, Hidefumi Kinoshita

Objective

We analyzed robotic partial nephrectomy (RPN) outcomes in obese patients based on body mass index (BMI) and trifecta achievement.

Methods

We retrospectively reviewed 296 patients who underwent RPN at Kansai Medical University Hospital between 2014 and 2022. The preoperative clinical data and perioperative outcomes were evaluated. Trifecta achievement (negative surgical margin, no major complications, and no acute kidney injury on postoperative day three) and its relationship to three BMI groups (<25, 25 to <30, and ≥30) were the primary outcome. The correlation between factors in achieving trifecta and BMI was evaluated. Univariate and multivariate analyses assessed variables for achieving the trifecta with logistic regression analysis. C-statistics quantitatively evaluated the prediction accuracy.

Results

Among 296 patients, 264 (89.2%) achieved trifecta (BMI categories were <25 [89.9%], 25 to <30 [89.4%], and ≥30 [82.6%]). There was no significant BMI-related difference (p = 0.566). Intraoperative blood loss increased with the BMI (p = 0.034). Multivariate analyses showed preoperative aspects and dimensions used for anatomic (PADUA) score independently predicted trifecta failure (odds ratio 1.71; 95% confidence interval 1.32–2.20; p < 0.001). The C-statistics of the PADUA score increased with increasing BMI.

Conclusions

Higher BMI patients had more intraoperative blood loss during RPN. However, RPN remains safe and has acceptable quality and functional outcomes. Since patients with high PADUA scores combined with a high BMI may be at risk of trifecta failure, this should be explained before RPN.

目的我们根据体重指数（BMI）和三围结果分析了肥胖患者接受机器人肾部分切除术（RPN）的结果：我们回顾性分析了2014年至2022年期间在关西医科大学附属医院接受RPN手术的296名患者。对术前临床数据和围手术期结果进行了评估。三项指标（手术切缘阴性、无重大并发症、术后第三天无急性肾损伤）及其与三个体重指数组的关系（结果：在 296 名患者中，有 264 人（89.2%）达到了三重标准（BMI 分类为结论：BMI 较高的患者在 RPN 过程中术中失血较多。然而，RPN 仍然是安全的，其质量和功能结果也是可以接受的。由于 PADUA 评分高且体重指数（BMI）高的患者可能面临三连冠失败的风险，因此在进行 RPN 之前应对此进行解释。

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引用次数: 0

Comparison of the efficacy of a pulsed thulium YAG laser versus a holmium YAG laser on dusting lithotripsy: In vitro analysis using an optical motion capture system 脉冲铥YAG激光与钬YAG激光在除尘碎石方面的功效比较：使用光学运动捕捉系统进行体外分析。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-26 DOI: 10.1111/iju.15548

Kazuyoshi Nakao MD, Takashi Yoshida MD, PhD, Kenta Takayasu MD, PhD, Keiki Chuman DVM, Tadao Matsunaga BE, PhD, Hidefumi Kinoshita MD, PhD

引用次数: 0

Risk factors for 30-day complications following ureteral reimplantation for vesicoureteral reflux in children 儿童膀胱输尿管反流输尿管再植术后 30 天并发症的风险因素。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-24 DOI: 10.1111/iju.15549

Mohamed Zouari MD, Manel Belhajmansour MD, Najoua Ben Kraiem MD, Hana Ben Ameur MD, Mahdi Ben Dhaou MD, Riadh Mhiri MD

引用次数: 0

Pneumovesical vesicovaginal fistula repair: Lessons learned from an initial series of 25 patients 气管膀胱阴道瘘修补术：从最初的 25 例患者中汲取的经验教训。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-22 DOI: 10.1111/iju.15508

Byeong Jo Jeon, Bum Sik Tae, Jeong Wan Yoo, Ho Young Koo, Cheol Young Oh, Jae Young Park, Jae Hyun Bae

Objectives

This study aims to share the experiences and outcomes of laparoscopic pneumovesical repair for vesicovaginal fistulas (VVF).

Materials and methods

A retrospective review of medical records from a single institution over 10 years was conducted. The focus was on patients who underwent VVF repair using a pneumovesical approach with three 5 mm laparoscopic ports. The study evaluated perioperative parameters, postoperative outcomes, and complication rates to assess the efficacy and safety of this surgical method. Cumulative sum (CUSUM) analysis was used to determine the learning curve based on operative time.

Results

Of the 26 patients with VVF, 23 (88.5%) had successful fistula closure after the first surgery. One patient required open surgery conversion due to challenges in maintaining pneumovesicum, and two experienced recurrences, although successful repairs were achieved in subsequent surgeries. The average patient age was 47.4 years, with a mean operative time of 99.9 min. The postoperative hospital stay averaged 9.1 days, and catheterization lasted about 11 days. The CUSUM chart indicated a learning curve, with fluctuations until the 19th case, followed by a consistent upward pattern.

Conclusion

Laparoscopic pneumovesical VVF repair is an effective and safe technique, especially suitable for fistulas near the ureteral orifice or deep in the vaginal cavity. The method demonstrates favorable outcomes with minimal complications and allows for easy reoperation if necessary.

研究目的本研究旨在分享膀胱阴道瘘（VVF）腹腔镜气腹修补术的经验和结果：对一家医疗机构 10 年来的医疗记录进行了回顾性审查。研究重点是使用气腹方法和三个 5 毫米腹腔镜孔进行膀胱阴道瘘修补术的患者。研究评估了围手术期参数、术后效果和并发症发生率，以评估这种手术方法的有效性和安全性。研究采用累积总和（CUSUM）分析法来确定基于手术时间的学习曲线：结果：在 26 名 VVF 患者中，23 人（88.5%）在首次手术后成功关闭了瘘管。有一名患者因难以维持气闭而需要转为开放手术，有两名患者虽然在后续手术中成功修复，但仍出现复发。患者平均年龄为 47.4 岁，平均手术时间为 99.9 分钟。术后平均住院时间为 9.1 天，导尿时间约为 11 天。CUSUM图表显示了一条学习曲线，在第19个病例之前有波动，随后呈持续上升模式：腹腔镜气腹 VVF 修补术是一种有效且安全的技术，尤其适用于输尿管口附近或阴道深处的瘘管。该方法疗效显著，并发症极少，必要时可轻松进行再次手术。

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引用次数: 0

Changes in the treatment landscape of metastatic hormone-sensitive prostate cancer following approval of upfront androgen receptor signaling inhibitors: A multicenter study 前期雄激素受体信号抑制剂获批后转移性激素敏感性前列腺癌治疗格局的变化：一项多中心研究。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-19 DOI: 10.1111/iju.15546

Fumihiko Urabe, Katsuki Muramoto, Takafumi Yanagisawa, Wataru Fukuokaya, Keiichiro Mori, Kojiro Tashiro, Kota Katsumi, Hidetsugu Takahashi, Kentaro Yoshihara, Keiichiro Miyajima, Yu Imai, Kosuke Iwatani, Sotaro Kayano, Taro Igarashi, Masaya Murakami, Shunsuke Tsuzuki, Tatsuya Shimomura, Hiroki Yamada, Jun Miki, Takahiro Kimura, JIKEI-YAYOI Collaborative Group

Background

A multicenter database was utilized to examine the current treatment landscape and clinical outcomes among patients with metastatic hormone-sensitive prostate cancer (mHSPC) following approval of upfront androgen receptor signaling inhibitors (ARSIs).

Methods

We retrospectively analyzed patients with mHSPC who commenced treatment between February 2018 and June 2023. The Kaplan–Meier method was used to assess oncological outcomes, including time to castration-resistant prostate cancer (CRPC), progression-free survival 2 (PFS2, duration from initial treatment to tumor progression during second-line treatment), cancer-specific survival (CSS), and overall survival (OS). Cox regression analyses were performed to determine the impact of treatment choices on oncological outcomes. In addition, the incidence rate of adverse events was assessed.

Results

In total, 829 patients were analyzed; 42.5% received ARSIs with androgen deprivation therapy (ADT), 44.0% received combined androgen blockade (CAB), and 13.5% received ADT alone. Kaplan–Meier curves and multivariate Cox regression analyses indicated higher rates of CRPC and shorter PFS2 in patients treated with CAB versus ARSIs with ADT. By contrast, CSS and OS were not significantly different between the ARSI with ADT group and the CAB group. Grades 3–4 adverse events occurred in 1.9% of patients receiving CAB and 6.0% of those receiving ARSIs with ADT.

Conclusions

Initial treatment with ARSIs in combination with ADT resulted in a longer time to CRPC and longer PFS2 compared to CAB. Although CAB and ADT alone were associated with fewer adverse events, ARSIs with ADT should be considered a first-line treatment option given its superior oncological outcomes.

背景：我们利用一个多中心数据库来研究转移性激素敏感性前列腺癌（mHSPC）患者在前期雄激素受体信号转导抑制剂（ARSIs）获批后的治疗现状和临床结果：我们对2018年2月至2023年6月期间开始治疗的mHSPC患者进行了回顾性分析。采用卡普兰-梅耶法评估肿瘤学结果，包括发生阉割耐药前列腺癌（CRPC）的时间、无进展生存期2（PFS2，二线治疗期间从初始治疗到肿瘤进展的持续时间）、癌症特异性生存期（CSS）和总生存期（OS）。为确定治疗选择对肿瘤结果的影响，进行了 Cox 回归分析。此外，还评估了不良事件的发生率：共对829名患者进行了分析，其中42.5%的患者在接受ARSI治疗的同时接受雄激素剥夺治疗（ADT），44.0%的患者接受联合雄激素阻断治疗（CAB），13.5%的患者仅接受ADT治疗。Kaplan-Meier曲线和多变量Cox回归分析表明，接受CAB治疗的患者与接受ARSIs和ADT治疗的患者相比，CRPC发生率更高，PFS2更短。相比之下，ARSI与ADT组和CAB组的CSS和OS无明显差异。接受CAB治疗的患者中有1.9%发生了3-4级不良事件，而接受ARSIs联合ADT治疗的患者中有6.0%发生了3-4级不良事件：结论：与CAB相比，ARSIs联合ADT的初始治疗可延长患者的CRPC时间和PFS2。尽管 CAB 和 ADT 单独治疗的不良反应较少，但鉴于 ARSIs 与 ADT 联合治疗具有更优越的肿瘤治疗效果，因此应将其视为一线治疗方案。

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引用次数: 0

Clinical characteristics and predictors of long-term postoperative urinary incontinence in patients treated with robot-assisted radical prostatectomy: A propensity-matched analysis 机器人辅助前列腺癌根治术患者术后长期尿失禁的临床特征和预测因素：倾向匹配分析

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-17 DOI: 10.1111/iju.15533

Yuki Kohada, Hiroyuki Kitano, Ryo Tasaka, Shunsuke Miyamoto, Tomoya Hatayama, Hiroyuki Shikuma, Kyohsuke Iwane, Kazuma Yukihiro, Kenshiro Takemoto, Miki Naito, Kohei Kobatake, Yohei Sekino, Keisuke Goto, Akihiro Goriki, Keisuke Hieda, Nobuyuki Hinata

Objectives

This study aimed to elucidate the clinical characteristics and predictors of long-term postoperative urinary incontinence (PUI) after robot-assisted radical prostatectomy (RARP).

Methods

This study included patients who underwent RARP at our institution and were stratified into PUI (≥1 pad/day) and continence (0 pad/day) groups at 60 months after RARP. A propensity score-matched analysis with multiple preoperative urinary status (Expanded Prostate Cancer Index Composite urinary subdomains, total International Prostate Symptom Score (IPSS), and IPSS-quality of life scores) was performed to match preoperative urinary status in these groups. Serial changes in urinary status and treatment satisfaction preoperatively and until 60 months after RARP were compared, and predictors of long-term PUI were assessed using multivariate logistic regression analysis.

Results

A total of 228 patients were included in the PUI and continence groups (114 patients each). Although no significant difference in preoperative urinary status was observed between the two groups, the postoperative urinary status significantly worsened overall in the PUI group than in the continence group. Treatment satisfaction was also significantly lower in the PUI group than in the continence group from 12 to 60 months postoperatively. Multivariate logistic regression analysis revealed that age (≥70 years) and biochemical recurrence (BCR) were significant predictors of the long-term PUI group (p < 0.05).

Conclusions

Patients with long-term PUI had poor overall postoperative urinary status and lower treatment satisfaction than the continence group. Considering the age and risk of BCR is important for predicting long-term PUI when performing RARP.

研究目的本研究旨在阐明机器人辅助前列腺癌根治术（RARP）术后长期尿失禁（PUI）的临床特征和预测因素：本研究纳入了在我院接受前列腺癌根治术（RARP）的患者，并在RARP术后60个月时将其分为PUI组（尿垫≥1片/天）和尿失禁组（尿垫0片/天）。为了匹配这两组患者的术前排尿状况，我们对他们进行了倾向得分匹配分析，并采用了多种术前排尿状况（前列腺癌扩展指数综合排尿亚域、国际前列腺症状总评分（IPSS）和 IPSS-生活质量评分）。比较术前和 RARP 术后 60 个月前排尿状况和治疗满意度的连续变化，并使用多变量逻辑回归分析评估长期 PUI 的预测因素：共有 228 名患者被纳入 PUI 组和尿失禁组（各 114 人）。虽然两组患者术前排尿状况无明显差异，但 PUI 组患者术后排尿状况总体上明显差于失禁组。从术后 12 个月到 60 个月，PUI 组的治疗满意度也明显低于失禁组。多变量逻辑回归分析表明，年龄（≥70 岁）和生化复发（BCR）是长期 PUI 组的重要预测因素（P 结论：长期 PUI 组患者的总体情况较差：与尿失禁组相比，长期 PUI 患者的术后总体排尿状况较差，治疗满意度较低。在实施 RARP 时，考虑年龄和 BCR 风险对于预测长期 PUI 非常重要。

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引用次数: 0

Significance of androgen-deprivation therapy for intermediate- and high-risk prostate cancer treated with high-dose radiotherapy: A literature review 雄激素剥夺疗法对接受大剂量放疗的中高危前列腺癌的意义：文献综述。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-17 DOI: 10.1111/iju.15535

Rihito Aizawa, Hitoshi Ishikawa, Manabu Kato, Shosei Shimizu, Takashi Mizowaki, Yasuo Kohjimoto, Shiro Hinotsu, Isao Hara, the working group of the Japanese Urological Association Clinical Practice Guideline for Prostate Cancer 2023

The real-world benefits of adding androgen-deprivation therapy (ADT) and its optimal duration when combined with current standard high-dose radiation therapy (RT) remain unknown. We aimed to assess the efficacy of and toxicities associated with ADT in the setting of combination with high-dose RT for intermediate-risk (IR) and high-risk (HR) prostate cancer (PCa). This article is a modified and detailed version of the commentary on Clinical Question 8 described in the Japanese Clinical Practice Guidelines for Prostate Cancer (ver. 2023). A qualitative systematic review was performed according to the Minds Guide. All relevant published studies between September 2010 and August 2020, which assessed the outcomes of IR or HR PCa treated with high-dose RT, were screened using two databases (PubMed and ICHUSHI). A total of 41 studies were included in this systematic review, mostly consisting of retrospective studies (N = 34). The evidence basically supports the benefit of adding ADT to high-dose RT to improve tumor control. Regarding IR populations, many studies suggested the existence of a subgroup for which adding ADT had no impact on either overall survival or the BF-free duration. On the other hand, regarding HR populations, several studies suggested the positive impact of adding ADT for ≥1 year on overall survival. Adding ADT increases not only the risk of sexual dysfunction but also that of cardiovascular toxicities or bone fracture. Although the benefit of adding ADT was basically suggested for both IR and HR populations, further investigations are warranted to identify subgroups of patients for whom ADT has no benefit, as well as the appropriate duration of ADT for those who do derive benefit.

在现实世界中，增加雄激素剥夺疗法（ADT）的益处及其与当前标准大剂量放射治疗（RT）相结合的最佳持续时间仍是未知数。我们旨在评估中危（IR）和高危（HR）前列腺癌（PCa）联合大剂量 RT 时 ADT 的疗效和相关毒性。本文是对《日本前列腺癌临床实践指南》（第 2023 版）中所述临床问题 8 评注的详细修改。根据《明德指南》进行了定性系统回顾。利用两个数据库（PubMed 和 ICHUSHI）筛选了 2010 年 9 月至 2020 年 8 月间发表的所有相关研究，这些研究评估了接受高剂量 RT 治疗的 IR 或 HR PCa 的疗效。本系统综述共纳入了 41 项研究，其中大部分为回顾性研究（N = 34）。证据基本支持在大剂量 RT 的基础上加用 ADT 有助于提高肿瘤控制率。关于IR人群，许多研究表明存在这样一个亚组，即添加ADT对总生存期或无BF持续时间均无影响。另一方面，对于HR人群，一些研究表明，添加ADT≥1年对总生存期有积极影响。增加 ADT 不仅会增加性功能障碍的风险，还会增加心血管毒性或骨折的风险。虽然增加 ADT 对 IR 和 HR 两类人群基本都有益处，但仍有必要进行进一步研究，以确定 ADT 对哪些亚组患者无益，以及 ADT 对哪些患者有益处的适当持续时间。

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引用次数: 0

Editorial Comment to “Efficacy and safety of dose-dense gemcitabine plus cisplatin as neoadjuvant chemotherapy for muscle-invasive bladder cancer” 剂量密集型吉西他滨加顺铂作为肌肉浸润性膀胱癌新辅助化疗的有效性和安全性》的编辑评论。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-16 DOI: 10.1111/iju.15541

Eiji Kikuchi MD, PhD, Nozomi Hayakawa MD, PhD

引用次数: 0

Sarcopenia as a predictor of mortality in kidney transplant recipients: A 5-year prospective cohort study with propensity score matching 作为肾移植受者死亡率预测因素的 "肌肉疏松症"：一项为期 5 年的前瞻性队列研究与倾向得分匹配。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-16 DOI: 10.1111/iju.15539

Akihiro Kosoku, Tomoaki Iwai, Kazuya Kabei, Shunji Nishide, Yuichi Machida, Takuma Ishihara, Junji Uchida

Background

Sarcopenia is known to bring about adverse outcomes in elderly populations and dialysis patients. However, whether it is a risk factor in kidney transplant recipients (KTRs) has not yet been established. In the present study, the association of sarcopenia with mortality was investigated in KTRs.

Methods

We conducted a single-center prospective cohort study and recruited KTRs who were more than 1-year posttransplant from August 2017 to January 2018. The participants were followed for 5 years, and the Kaplan–Meier method and Cox proportional hazards model were used to assess patient survival.

Results

A total of 212 KTRs with a median age of 54 years and median transplant vintage of 79 months were enrolled in this study. Among them, 33 (16%) had sarcopenia according to the Asia Working Group for Sarcopenia 2019 at baseline. During the 5-year follow-up period, 20 (9.4%) died, 5 returned to dialysis after graft loss, and 4 were lost to follow-up. The 5-year overall survival rate was 90%. After 1:1 propensity score matching, a matched cohort with 60 KTRs was generated. The overall survival rate was significantly lower in the sarcopenia group compared to the non-sarcopenia group (p = 0.025, log-rank test). Furthermore, mortality risk was significantly higher in the sarcopenia group compared to the non-sarcopenia group (hazard ratio = 7.57, 95% confidence interval = 0.94–62).

Conclusion

Sarcopenia was a predictor of mortality in KTRs. KTRs with suboptimal muscle status who were at risk for poor survival could have a clinical benefit by interventions for sarcopenia.

背景：众所周知，肌肉疏松症会给老年人群和透析患者带来不良后果。然而，它是否是肾移植受者（KTRs）的一个风险因素尚未确定。本研究调查了肌肉疏松症与肾移植受者死亡率的关系：我们开展了一项单中心前瞻性队列研究，从 2017 年 8 月至 2018 年 1 月招募了移植后超过 1 年的 KTR。对参与者进行了为期5年的随访，并采用Kaplan-Meier法和Cox比例危险模型评估患者的生存情况：本研究共纳入212名KTR患者，中位年龄为54岁，中位移植年限为79个月。其中，33 人（16%）在基线时根据亚洲肌少症工作组 2019 年的标准患有肌少症。在 5 年的随访期间，20 人（9.4%）死亡，5 人在移植物丢失后重返透析，4 人失去随访。5年总存活率为90%。经过 1:1 倾向评分匹配后，产生了一个包含 60 名 KTR 的匹配队列。与非肌肉疏松症组相比，肌肉疏松症组的总存活率明显较低（p = 0.025，log-rank 检验）。此外，与非肌少症组相比，肌少症组的死亡风险明显更高（危险比 = 7.57，95% 置信区间 = 0.94-62）：肌少症是预测 KTR 死亡率的一个因素。结论：肌肉疏松症是预测 KTR 死亡率的一个因素，对肌肉状况欠佳且有生存风险的 KTR 患者进行肌肉疏松症干预，可为其带来临床益处。

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引用次数: 0

Local treatment benefits patients with oligometastatic prostate cancer: A systematic review and meta-analysis 局部治疗有益于少转移性前列腺癌患者：系统回顾和荟萃分析。

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2024-07-16 DOI: 10.1111/iju.15540

Qihao Sun, Kun Du, Shulei Sun, Yuxin Liu, Houtao Long, Daofeng Zhang, Junhao Zheng, Xiaoliang Sun, Yong Zhao, Haiyang Zhang

Objectives

This study aims to evaluate the efficacy of local treatment (LT), including radiotherapy (RT) and cytoreductive prostatectomy (CRP), in improving outcomes for patients with oligometastatic prostate cancer (OmPCa).

Methods

A systematic review and meta-analysis of articles from PubMed, Embase, and Web of Science published between 2010 and November 2023 were conducted. The study included 11 articles, comprising three randomized controlled trials (RCTs) and eight retrospective analyses. The study assessed overall survival (OS), radiographic progression-free survival (rPFS), prostate-specific antigen (PSA) PFS, cancer-specific survival (CSS), and complication rate (CR).

Results

OS was significantly improved in the LT group, with both RCTs and non-RCTs showing statistical significance [hazard ratios (HR) = 0.64; 95% confidence intervals (95% CIs), 0.51–0.80; p < 0.0001; HR = 0.55; 95% CIs, 0.40–0.77; p = 0.0004]. For rPFS, RCTs did not show statistically significant outcomes (HR = 0.60; 95% CIs, 0.34–1.07; p = 0.09), whereas non-RCTs demonstrated significant results (HR = 0.42; 95% CIs, 0.24–0.72; p = 0.002). Both RCTs and non-RCTs showed a significant improvement in PSA-PFS (HR = 0.44; 95%CI, 0.29–0.67; p = 0.0001; HR = 0.51; 95% CIs, 0.32–0.81; p = 0.004). For CSS, RCTs demonstrated statistical differences (HR = 0.65; 95% CIs, 0.47–0.90; p = 0.009), whereas non-RCTs did not (HR = 0.61; 95% CIs, 0.29–1.27; p = 0.19). Regarding CR, the risk difference was −0.22 (95% CIs, −0.32 to −0.12; p < 0.00001).

Conclusion

LT significantly improved OS and PFS in patients with OmPCa. Further RCTs are necessary to confirm these results.

研究目的本研究旨在评估局部治疗（LT），包括放射治疗（RT）和细胞修复性前列腺切除术（CRP）在改善寡转移性前列腺癌（OmPCa）患者预后方面的疗效：对2010年至2023年11月期间发表在PubMed、Embase和Web of Science上的文章进行了系统综述和荟萃分析。研究共纳入11篇文章，包括3项随机对照试验（RCT）和8项回顾性分析。研究评估了总生存期（OS）、放射学无进展生存期（rPFS）、前列腺特异性抗原（PSA）无进展生存期、癌症特异性生存期（CSS）和并发症发生率（CR）：结果：LT组的OS明显改善，RCTs和非RCTs均显示出统计学意义[危险比（HR）=0.64；95%置信区间（95% CIs），0.51-0.80；P 结论：LT能明显改善前列腺癌患者的OS和PFS：LT能明显改善OmPCa患者的OS和PFS。有必要进行更多的 RCT 研究来证实这些结果。

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引用次数: 0