■本研究旨在验证不进行活检的前列腺切除术的可行性和短期预后。
■PSA水平升高4至30ng/mL的患者计划进行多参数(mp)MRI和18F标记的前列腺特异性膜抗原(PSMA)正电子发射断层扫描(PET)。纳入47例前列腺影像学报告和数据系统≥4且分子影像学PSMA评分≥2的患者(cT2N0M0)。所有候选人都接受了机器人辅助的腹腔镜前列腺癌根治术,没有活检。前列腺癌检出率,索引肿瘤定位对应率,切缘阳性,并发症,术后住院时间,收集术后6周随访的PSA水平。
■所有mpMRI和PSMAPET阳性的患者均诊断为有临床意义的前列腺癌。共有80个病灶经病理证实为癌,其中63个癌症病灶为临床显著的前列腺癌。通过mpMRI和PSMAPET同时发现51个病灶。在任何一幅图像上都看不到总共23个病变,所有病变均≤国际泌尿外科病理学会2或≤15mm。mpMRI联合PSMAPET发现45例(95.7%)指示性肿瘤与病理相符。9例患者报告手术切缘阳性。
■对于严格通过mpMRI结合18F-PSMAPET/CT进行评估的患者,无活检前列腺切除术是安全可行的。
UNASSIGNED: This
study aimed to verify the feasibility and short-term prognosis of prostatectomy without biopsy.
UNASSIGNED: Patients with a rising PSA level ranging from 4 to 30 ng/mL were scheduled for multiparametric (mp) MRI and 18F-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET). Forty-seven patients (cT2N0M0) with Prostate Imaging Reporting and Data System ≥ 4 and molecular imaging PSMA score ≥ 2 were enrolled. All candidates underwent robot-assisted laparoscopic radical prostatectomy without biopsy. Prostate cancer detection rate, index tumors localization correspondence rate, positive surgical margin, complications, postoperative hospital stay, and PSA level in a 6-week postoperative follow-up visit were collected.
UNASSIGNED: All the patients with positive mpMRI and PSMA PET were diagnosed with clinically significant prostate cancer. A total of 80 lesions were verified as cancer by pathology, of which 63 cancer lesions were clinically significant prostate cancer. Fifty-one lesions were simultaneously found by mpMRI and PSMA PET. A total of 23 lesions were invisible on either image, and all lesions were ≤ International Society of Urological Pathology 2 or ≤ 15 mm. Forty-five (95.7%) index tumors found by mpMRI combined with PSMA PET were consistent with pathology. Nine patients reported positive surgical margin.
UNASSIGNED: Biopsy-free prostatectomy is safe and feasible for patients with evaluation strictly by mpMRI combined with 18F-PSMA PET/CT.