病理分期:前列腺因子

X. Rébillard
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引用次数: 0

摘要

大多数前列腺恶性肿瘤是腺癌。使用预处理临床或病理特征的形态图预测根治性前列腺切除术后生化或临床复发的概率。这些预测工具不能用于抗癌治疗的决策。准确的病理分期只能在根治性前列腺切除术标本检查后才能确定。术后x线图也可以根据预处理PSA水平、活检和前列腺切除术样本的Gleason评分、组织学分级、是否存在阳性手术切缘、精囊受损伤、囊膜穿透和淋巴结转移来预测无进展生存的概率。回顾性研究证实,这些病理治疗后参数是临床和生化进展的危险因素。这些不利的参数,连同根治性前列腺切除术前一年的PSA速度,可以预测局部复发和远处扩散的风险。对于这类被认为有高风险进展的前列腺癌患者,在初始局部治疗后,应给予辅助治疗,这是科学界的共识。
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Pathological stage: pronostic factors

Most of prostatic malignancies are adenocarcinomas. Nomograms using pretreatment clinical or pathological features predict the probability of biochemical or clinical relapse after radical prostatectomy. These predictive tools must not be used in decision making for the anticancer treatment. The accurate pathological stage can only be assessed after examination of the radical prostatectomy specimens. Postoperative nomograms can be also used to predict the probability of survival without progression on the basis of pretreatment PSA level, the Gleason score of the biopsy and prostatectomy samples, the histological grading, the presence or absence of positive surgical margins, involvement of seminal vesicles, capsular penetration and lymph-node metastases. Retrospective studies have confirmed that these pathological post-treatment parameters are risk factors for clinical and biochemical progression. These unfavourable parameters, along with the PSA velocity during the year before radical prostatectomy, predict the risk of local relapse and distant dissemination. Scientific consensus exists for prescribing an adjuvant therapy after the initial local treatment for this population of patients with carcinoma of the prostate who are considered at high risk of progression.

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来源期刊
Annales D Urologie
Annales D Urologie 医学-泌尿学与肾脏学
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