PDF(Pubmed)
Abstract：
Radical prostatectomy (RP) combined with pelvic lymph node dissection (PLND) is the first step in multimodal treatment of prostate cancer (PCa) without distant metastases. For a long time, the surgical resection range has been highly dependent on the surgeon\'s visualization and experience with preoperative imaging. With the rapid development of prostate-specific membrane antigen positron emission tomography and single-photon emission computed tomography (PSMA-PET and PSMA-SPECT), PSMA-targeted surgery has been introduced for a more accurate pathological diagnosis and complete resection of positive surgical margins (PSMs) and micro-lymph node metastases (LNMs). We reviewed PSMA-targeted surgeries, including PSMA-PET-guided prostatic biopsy (PSMA-TB), PSMA-targeted radio-guided surgery (PSMA-RGS), PSMA-targeted fluorescence-guided surgery (PSMA-FGS), and multi-modality/multi-targeted PSMA-targeted surgery. We also discuss the strengths and challenges of PSMA-targeted surgery, and propose that PSMA-targeted surgery could be a great addition to existing surgery protocols, thereby improving the accuracy and convenience of surgery for primary and recurrent PCa in the near future.
摘要：
根治性前列腺切除术（RP）联合盆腔淋巴结清扫术（PLND）是多模式治疗无远处转移的前列腺癌（PCa）的第一步。很长一段时间,手术切除范围高度依赖于外科医生的视觉和术前成像经验。随着前列腺特异性膜抗原正电子发射断层扫描和单光子发射计算机断层扫描(PSMA-PET和PSMA-SPECT)的迅速发展,已引入PSMA靶向手术，以更准确地进行病理诊断，并完全切除阳性手术切缘（PSM）和微淋巴结转移（LNM）。我们回顾了PSMA靶向手术，包括PSMA-PET引导下的前列腺活检（PSMA-TB），PSMA靶向放射引导手术（PSMA-RGS）PSMA靶向荧光引导手术（PSMA-FGS），和多模式/多靶向PSMA靶向手术。我们还讨论了PSMA靶向手术的优势和挑战，并提出PSMA靶向手术可能是现有手术方案的一个很好的补充，从而在不久的将来提高原发性和复发性PCa手术的准确性和便利性。
