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目的探讨偶发性前列腺癌患者的最佳治疗方法。方法2001年1月～2005年1月,对18例前列腺增生症行TURP术后病理证实为前列腺癌的病人,先行新辅助治疗后,进而行前列腺痛根治术,满意效果。新辅助治疗方案包括(1)诺雷德+Flutamide(氟他胺):(2)诺雷德+Casodex(康士德),用药时间为3月,用药期间监测PSA。手术方法为标准的保留勃起神经的前列腺癌根治术。结果所有病人药物耐受性良好,手术和围手术期过程顺利。术后随访6月～3年4个月,平均12月,12例膀胱控尿正常,3个月时有轻度压力性尿失禁6例,6个月时有2例,无真性尿失禁发生。随访期间18例病人血清PSA均<0．01μg／L,未发现肿瘤局部复发以及远处转移征象。7例患者保持性功能正常。结论前列腺癌根治术是偶发性前列腺癌患者的有效疗法。术前应用新辅助治疗3月,可使TURP术造成的创面完全愈合,减少根治手术的难度,同时控制前列腺癌的发展。
Objective To explore the best treatment for patients with sporadic prostate cancer. Methods From January 2001 to January 2005, 18 patients with benign prostatic hyperplasia who underwent TURP postoperative pathological diagnosis of prostate cancer were treated with neoadjuvant therapy and then radical prostatectomy with satisfactory results. Neoadjuvant regimens include (1) Norelide + Flutamide (2) Norelide + Casodex, administered for 3 months and PSA monitored during treatment. The surgical method is a standard radical prostatectomy that retains the erectile nerves. Results All patients were well tolerated and the procedure and perioperative procedure went well. The patients were followed up for 6 months to 3 years and 4 months, with an average of 12 months. Of the 12 cases, urinary bladder control was normal, 6 cases were mild stress urinary incontinence at 3 months, 2 cases were at 6 months, and true urinary incontinence occurred . During the follow-up period, the serum PSA of 18 patients were less than 0.01μg / L, and no local tumor recurrence and distant metastasis were found. Seven patients had normal sexual function. Conclusions Radical prostatectomy is an effective treatment for patients with sporadic prostate cancer. Preoperative application of neoadjuvant therapy in March, TURP can make the wound completely healed, reducing the difficulty of radical surgery, while controlling the development of prostate cancer.