PDF(Pubmed)
Abstract：
UNASSIGNED: The objective of this study is to evaluate the prevalence and the importance of preperitoneal vas deferens (VD) infiltration in high-risk prostate cancer (PCa).
UNASSIGNED: In this prospectively designed study, we included 332 high-risk PCa patients with a Briganti score >5%, who were treated by robot-assisted radical prostatectomy between July 2017 and February 2022 at the Urology Department, SLK Kliniken Heilbronn. In addition to the standard histological analysis of the distal VD, which was attached to the prostate specimen, we analysed the infiltration status of preperitoneal VD in this cohort. The preperitoneal VD, which represents the middle part of ductus deferens and extends between the internal inguinal ring and obturator fossa, was resected during extended pelvic lymphadenectomy. Distal and preperitoneal VD status was registered together with preoperative and postoperative disease characteristics. Descriptive analysis methods and logistic regression analysis were used.
UNASSIGNED: Briganti score of the target cohort had a median value of 19%, while 235 patients (70.8%) of the group demonstrated a locally advanced disease. The Grade Group at prostatectomy specimen was at least 3 for 286 patients (86.1%). Distal VD infiltration was found in 20 patients (6%) and preperitoneal VD infiltration in two patients (0.6%). Distal VD infiltration was not associated with an increased possibility for positive surgical margins or nodal status among pT3b patients, while both patients with preperitoneal VD infiltration were characterized by highly aggressive disease in locally advanced stage and bilateral distal VD infiltration.
UNASSIGNED: PCa extension along VD may reach a more proximal point of VD than the reported from the existing data infiltration of VD adjacent to seminal vesicles. This rare manifestation of PCa local extension may be the intermediate step to the rare cases of recurrence in the testicles. However, more robust data are needed to confirm the aforementioned hypothesis. Distal VD infiltration seems to have no additional prognostic value among patients with infiltrated seminal vesicles.
UNASSIGNED: In this prospectively designed study, we included 332 high-risk PCa patients with a Briganti score >5%, who were treated by robot-assisted radical prostatectomy between July 2017 and February 2022 at the Urology Department, SLK Kliniken Heilbronn. In addition to the standard histological analysis of the distal VD, which was attached to the prostate specimen, we analysed the infiltration status of preperitoneal VD in this cohort. The preperitoneal VD, which represents the middle part of ductus deferens and extends between the internal inguinal ring and obturator fossa, was resected during extended pelvic lymphadenectomy. Distal and preperitoneal VD status was registered together with preoperative and postoperative disease characteristics. Descriptive analysis methods and logistic regression analysis were used.
UNASSIGNED: Briganti score of the target cohort had a median value of 19%, while 235 patients (70.8%) of the group demonstrated a locally advanced disease. The Grade Group at prostatectomy specimen was at least 3 for 286 patients (86.1%). Distal VD infiltration was found in 20 patients (6%) and preperitoneal VD infiltration in two patients (0.6%). Distal VD infiltration was not associated with an increased possibility for positive surgical margins or nodal status among pT3b patients, while both patients with preperitoneal VD infiltration were characterized by highly aggressive disease in locally advanced stage and bilateral distal VD infiltration.
UNASSIGNED: PCa extension along VD may reach a more proximal point of VD than the reported from the existing data infiltration of VD adjacent to seminal vesicles. This rare manifestation of PCa local extension may be the intermediate step to the rare cases of recurrence in the testicles. However, more robust data are needed to confirm the aforementioned hypothesis. Distal VD infiltration seems to have no additional prognostic value among patients with infiltrated seminal vesicles.
摘要：
■这项研究的目的是评估高危前列腺癌（PCa）中腹膜前输精管（VD）浸润的患病率和重要性。
■在这项前瞻性设计的研究中，我们纳入332例Briganti评分>5%的高危PCa患者，2017年7月至2022年2月在泌尿外科接受机器人辅助前列腺癌根治术治疗的患者，SLKKlinikenHeilbronn.除了远端VD的标准组织学分析，附着在前列腺样本上，我们分析了该队列中腹膜前VD的浸润状况.腹膜前VD,代表输精管的中间部分，在腹股沟内环和闭孔窝之间延伸，在扩大盆腔淋巴结清扫术中切除。远端和腹膜前VD状态与术前和术后疾病特征一起记录。采用描述性分析方法和logistic回归分析。
■目标队列的Briganti得分的中位数为19％，而该组中的235例患者（70.8%）表现为局部晚期疾病。对于286例患者，前列腺切除术标本的等级组至少为3（86.1％）。远端VD浸润20例（6％），腹膜前VD浸润2例（0.6％）。远端VD浸润与pT3b患者中手术切缘阳性或淋巴结状态的可能性增加无关。而两名腹膜前VD浸润患者均表现为局部晚期高度侵袭性疾病和双侧远端VD浸润。
■沿VD延伸的PCa可能比从邻近精囊的VD的现有数据浸润所报告的更接近VD的点。PCa局部延伸的这种罕见表现可能是罕见的睾丸复发病例的中间步骤。然而,需要更可靠的数据来证实上述假设。在浸润性精囊患者中，远端VD浸润似乎没有额外的预后价值。
■在这项前瞻性设计的研究中，我们纳入332例Briganti评分>5%的高危PCa患者，2017年7月至2022年2月在泌尿外科接受机器人辅助前列腺癌根治术治疗的患者，SLKKlinikenHeilbronn.除了远端VD的标准组织学分析，附着在前列腺样本上，我们分析了该队列中腹膜前VD的浸润状况.腹膜前VD,代表输精管的中间部分，在腹股沟内环和闭孔窝之间延伸，在扩大盆腔淋巴结清扫术中切除。远端和腹膜前VD状态与术前和术后疾病特征一起记录。采用描述性分析方法和logistic回归分析。
■目标队列的Briganti得分的中位数为19％，而该组中的235例患者（70.8%）表现为局部晚期疾病。对于286例患者，前列腺切除术标本的等级组至少为3（86.1％）。远端VD浸润20例（6％），腹膜前VD浸润2例（0.6％）。远端VD浸润与pT3b患者中手术切缘阳性或淋巴结状态的可能性增加无关。而两名腹膜前VD浸润患者均表现为局部晚期高度侵袭性疾病和双侧远端VD浸润。
■沿VD延伸的PCa可能比从邻近精囊的VD的现有数据浸润所报告的更接近VD的点。PCa局部延伸的这种罕见表现可能是罕见的睾丸复发病例的中间步骤。然而,需要更可靠的数据来证实上述假设。在浸润性精囊患者中，远端VD浸润似乎没有额外的预后价值。
