A Preliminary Study Of Radical Prostatetomy Combined With Lymph Node Dissection In The Treatment Of Prostate Cancer

Objective:The purpose of this study is to investigate the safety and clinical efficacy of radical prostatectomy combined with lymph node dissection in the treatment of prostate cancer,and to provide clinical basis for radical prostatectomy and lymph node dissection in patients with high risk prostate cancer.Methods:53 patients who underwent radical prostatectomy and lymph node dissection in our hospital from January 2008 to December 2017 were analyzed retrospectively.According to D'Amico grading standard,fifty-three patients were divided into low and intermediate-risk group which is 20 cases and high-risk group which is 33 cases.The age,preoperative PSA and Gleason scores,operative complications,pathological results,postoperative urine control and biochemical recurrence were observed.The methods of follow-up included telephone follow-up,outpatient follow-up and so on.The data were analyzed by SPSS 17.0 statistical software.Results:The average age of all patients was 69.2 years,The average age of the patients in high risk group was(69.5±8.6)years,and that in low and intermediate-risk group was(68.9±4.6)years.There was no significant difference between the two groups(P>0.05).There was significant difference in preoperative PSA level and Gleason score between high risk group and low and intermediate-risk group(P<0 05).What is more,there was no significant difference in the average operation time and the average amount of intraoperative bleeding between the two groups(P>0.05),and there was no significant difference in the rate of rectal injury and intraoperative blood transfusion between the two groups(P>0.05).There was no significant difference in the time of indwelling catheter and hospitalization between he two groups(P>0.05).There was no significant difference in postoperative incision infection rate and urinary retention rate between high risk group and low and intermediate-risk group(P>0.05).There were no serious postoperative complications.There was no significant difference in urine control rate between 3 months and 6 months after operation(P>0.05),and there was no significant difference in resection margin positive rate and lymph node positive rate between the two groups(P>0.05).Among all the patients,there were 19 patients with biochemical recurrence after operation,including 5 in the low and intermediate-risk group,14 in the high-risk group,75% in the low and intermediate-risk group and 57.6% in the high-risk group,respectively.There was no significant difference(P>0.05).Multivariate analysis showed that the positive margin was the main influencing factor of postoperative biochemical recurrence in patients with prostate cancer.Conclusions:1.There is no significant difference in intraoperative and postoperative complications between high risk group and low and intermediate-risk group.2.There was no significant difference in biochemical recurrence-free survival rate and urine control between the high-risk group and the low and intermediate-risk group after radical resection of prostate cancer and lymph node dissection.3.The positive margin of resection is the main influencing factor of postoperative biochemical recurrence of prostate cancer.4.Radical prostatectomy combined with lymph node dissection is safe and feasible for high-risk patients with prostate cancer.