The Clinical Effect Of Radical Resection And Endocrine Therapy For Advanced Prostate Cancer

Introduction:Prostate cancer is one of the most common malignancies in the male genitourinary system and cancer mortality is lower than bronchial lung cancer and colorectal cancer.The main screening methods for suspected prostate cancer are the rectal examination and prostate specific antigen,and the diagnosis of prostate cancer needs the pathology of prostate biopsy.The main treatments for the advanced prostate cancer are endocrine therapy,chemotherapy,radiotherapy and immunotherapy.The effect of comprehensive treatment is poor,and some patients can be developed as castration resistant prostate cancer.Radical resection of prostate cancer as a cytoreductive surgery treatment of advanced prostate cancer lack of treatment of high-level evidence,and the guidelines have not yet recommended it to advanced prostate cancer.It is necessary to study the effect of radical resection of advanced prostate cancer as improvement of theory,clinical observation and the operation level.Objective:To investigate the clinical effect of radical resection and endocrine therapy for advanced prostate cancer,and to provide theoretical basis for surgical treatment of advanced prostate cancer.Methods:During the period from January 2012 to March 2017,retrospective analysis was done among the patients who were diagnosed of advanced prostate cancer.In total 135 patients who undergone endocrine therapy or radical resection were involved.We followed up for 12 months and analyzed the changes of prostate specific antigen and testosterone in patients.We use SPSS 20.0 software analysis to analyze the data.The results were expressed as mean ± standard deviation with t test or variance analysis.Classification of information were analyzed by chi-square test.The confidence interval was 95%and P<0.05 was statistically significant.Results:A total of 135 patients with advanced prostate cancer were enrolled in this study,including 70 cases who underwent radical resection of prostate cancer and 64 cases who underwent endocrine therapy.Compared with the group of radical resection,the age,total prostate specific antigen,free/total prostate specific antigen and alkaline phosphatase of endocrine therapy group were higher,and there were statistically differences.In the first month,3th month,6th month and 12th month after radical resection,total prostate specific antigen and free prostate specific antigen lower than endocrine treatment group.There was statistically difference between them except the 12th month of free prostate specific antigen.There were more cases whose serum total prostate specific antigen and free prostate specific antigen reduced to normal in the first month,3th month,6th month and 12th month in group of radical resection than the group of endocrine treatment.In the first month,3th month,6th month and 12th month after radical resection,free/total prostate specific antigen lower than endocrine treatment group,but there was no statistically difference between them.There were more cases of serum free/total prostate specific antigen reduced to normal in the 3th month,6th month and 12th month in group of radical resection than the group of endocrine treatment.In the first month,3th month,6th month and 12th month after surgery,testosterone higher than endocrine treatment group.There was statistically difference between them in the first month,3th month,6th month and there was no statistically difference in 12th month.Conclusion:Compared with endocrine therapy,radical prostatectomy can reduce the serum total prostate specific antigen,free prostate specific antigen levels,and there was no difference in free/total prostate specific antigens,but the level of testosterone lower than endocrine therapy.In addition,compared with endocrine therapy,radical resection of prostate cancer can increase the total number patients whose prostate specific antigens reduced to normal levels.