前列腺癌单纯睾丸切除术和假睾丸切除术的美容效果、HRQoL 和有效性。

IF 2.3 Q3 ONCOLOGY Prostate Cancer Pub Date : 2021-11-26 eCollection Date: 2021-01-01 DOI:10.1155/2021/9968570
Ijeoma N C Chibuzo, Augustine O Takure, Olayiwola B Shittu, Linus I Okeke
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引用次数: 0

摘要

简介:睾丸切除术是治疗局部晚期或转移性前列腺癌(LAMP)最具成本效益的激素疗法。然而,成本效益不应影响对健康相关生活质量(HRQoL)的考虑。双侧单纯睾丸切除术(BSO)与阴囊空虚造成的心理测量缺陷有关。本研究比较了 BSO 与双侧囊下睾丸切除术 (BSCO) 和双侧睾丸切除术 (BESO) 等内源性假睾丸技术的 HRQoL、疗效和外观吸引力。研究设计。尼日利亚 LAMP 患者被随机分为三个手术组:BSO、BSCO 和 BESO。在睾丸切除术前和术后三个月分别进行了前列腺癌扩展指数 Composite-26 HRQoL 和社会人口学问卷调查。血清睾酮和 PSA 分别在术后 0、1、2 和 3 小时、7 天和 3 个月进行测量。3个月后对假睾丸体积和外观进行评估:共招募了 63 名患者(24 名 BSO、21 名 BSCO、18 名 BESO),其中 73% 为低收入者。在三个月的随访期间,手术费用、PSA 或睾酮阈值均无明显差异(分别为 11.3、12.6、15.2 纳克/毫升(P=0.667)和 0.44、0.64、0.79 毫摩尔/升(P=0.603))。有假睾丸(BSCO、BESO)的人较少感到男性阳痿(P=0.010)。BSCO 产生的性困扰最小、性功能最高、假睾丸体积最大。各组的外观吸引力评分相似(分别为 77.9 ± 22.8、81 ± 13.9 和 81.9 ± 22.5,P=0.858):结论:与 BSO 相比,内源性假睾丸技术可在不增加费用的情况下减少患者的负面心理影响。BSCO产生的假睾丸体积和术后性功能最佳。本研究已在美国国立卫生研究院国家医学图书馆的 ClinicalTrials.gov 登记为 TEPSO 研究,NCT03744494:尼日利亚亚群前列腺癌患者双侧睾丸切除术三种技术的疗效和患者满意度比较。2018年11月16日完成注册(回顾性注册)NCT03744494。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Cosmetic Appeal, HRQoL, and Effectiveness of Simple and Pseudotesticular Techniques of Orchidectomy in Prostate Cancer.

Introduction: Orchidectomy is the most cost-effective means of hormonal therapy for locally advanced or metastatic prostate cancer (LAMP). However, cost-effectiveness should not detract from health-related quality of life (HRQoL) considerations. Bilateral simple orchidectomy (BSO) has been linked to negative psychometric deficits from an empty scrotum. This study compared the HRQoL, therapeutic efficacy, and cosmetic appeal of BSO with endogenous pseudotesticular techniques of bilateral subcapsular orchidectomy (BSCO) and bilateral-epididymal-sparing orchidectomy (BESO). Research Design. Nigerian patients with LAMP were randomised into three surgical arms: BSO, BSCO, and BESO. Expanded Prostate Cancer Index Composite-26 HRQoL and sociodemographic questionnaires were administered before and three months after orchidectomy. Serum testosterone and PSA were measured at 0, 1, 2, and 3 hours; 7 days; and 3 months postoperatively. Pseudotesticular volumes and cosmetic appeal were assessed at 3 months.

Result: Sixty-three patients were recruited (24 BSO, 21 BSCO, 18 BESO), 73% of whom were low-income earners. There was no significant difference in the procedure cost nor the PSA or testosterone nadirs achieved over the three-month follow-up period (11.3, 12.6, 15.2 ng/ml (p=0.667) and 0.44, 0.64, 0.79 nmol/l (p=0.603) respectively). Those with pseudotesticles (BSCO, BESO) felt less emasculated (p=0.010). BSCO produced the least sexual bother, highest sexual function, and largest pseudotesticular volumes. The cosmetic appeal scores were similar between groups (77.9 ± 22.8, 81 ± 13.9, and 81.9 ± 22.5, respectively, p=0.858).

Conclusion: Endogenous pseudotesticular techniques, when compared with BSO, reduce the negative psychological impact experienced by patients without increasing costs. BSCO produced the best pseudotesticular volumes and postoperative sexual function. This study is registered with the ClinicalTrials.gov of the National Institute of Health U.S. National Library of Medicine as TEPSO study, NCT03744494: Comparison of the Therapeutic Efficacy and Patient Satisfaction of Three Techniques of Bilateral Orchidectomy in Prostate Cancer Patients of a Nigerian Sub-population. Registration completed on 16th of November, 2018 (registered retrospectively) NCT03744494.

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来源期刊
Prostate Cancer
Prostate Cancer ONCOLOGY-
CiteScore
2.70
自引率
0.00%
发文量
9
审稿时长
13 weeks
期刊介绍: Prostate Cancer is a peer-reviewed, Open Access journal that provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. The journal publishes original research articles, review articles, and clinical studies related to the diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.
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