Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press50810.17650/1726-9776-2016-12-1-69-73DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. PROSTATE CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак предстательной железыImprovement of recurrence-free survival after radical prostatectomy for locally advanced prostate cancer in relation to the time of surgical interventionУлучшение безрецидивной выживаемости после радикальной простатэктомии при местно-распространенном раке предстательной железы в зависимости от срока оперативного вмешательстваVelievE. I.ВелиевЕ. И.
Russian Federation

Department of Urology and Operative Andrology, 2/1, Barrikadnaya St., Moscow, 125995;

5, Second Botkinsky Passage, Moscow, 125284

кафедра урологии и хирургической андрологии, 123995, Москва, ул. Баррикадная, 2/1;

125284, Москва, 2-й Боткинский проезд, 5

veliev@urotop.ruSokolovE. A.СоколовЕ. А.
Russian Federation

Department of Urology and Operative Andrology, 

2/1, Barrikadnaya St., Moscow, 125995

кафедра урологии и хирургической андрологии,

123995, Москва, ул. Баррикадная, 2/1

rmapo@yandex.ruLoranO. B.ЛоранО. Б.
Russian Federation

Department of Urology and Operative Andrology, 

2/1, Barrikadnaya St., Moscow, 125995

кафедра урологии и хирургической андрологии,

123995, Москва, ул. Баррикадная, 2/1

oleg_loran@gmail.comRussian Medical Academy of Postgraduate EducationГБОУ ДПО «Российская медицинская академия последипломного образования»S.P. Botkin City Clinical HospitalГКБ им. С.П. Боткина3003201612169730211201508122015https://oncourology.abvpress.ru/oncur/article/view/508

Objective: to comparatively estimate the frequency of a positive surgical margin and 5-year biochemical recurrent-free survival (BRFS) rates in patients with locally advanced prostate cancer in relation to the time of radical retropubic prostatectomy.

Subjects and methods. The investigation enrolled 274 patients with prostate cancer (pT3-4N0-1M0) who were divided into 2 groups of 68 and 20 patients operated on in 1997 to 2006 and 2007 to 2012, respectively. Two surgeons made surgical interventions by the standardized procedure. The 5-year BRFS rates were estimated using the Kaplan-Meier method and log-rank test. A biochemical recurrence was defined as a prostatespecific antigen level of t 0.2 ng / ml in 2 consecutive measurements or as the initiation of adjuvant therapy.

Results. The detection rate of a positive surgical margin decreased from 55.9 % in 1997–2006 to 37.9 % in 2007–2012 (p = 0.01); the 5-year recurrence-free survival rates were 38.8 % versus 66.2 % (p < 0.001).

Conclusion. These changes would probably be a result of surgeons» better experience and improved surgical techniques in the course of time.

Цель исследования – сравнительная оценка частоты положительного хирургического края и 5-летней выживаемости без биохимического рецидива у пациентов с местно-распространенным раком предстательной железы в зависимости от времени выполнения позадилонной радикальной простатэктомии.

Материалы и методы. В исследование включены 274 пациента (pT3–4N0–1M0), которые были разделены на 2 группы: 68 больных, оперированных в период с 1997 по 2006 г., и 206 – в период с 2007 по 2012 г. Оперативные вмешательства выполнялись двумя хирургами по стандартизированной методике. Пятилетнюю безрецидивную выживаемость оценивали с помощью метода Каплана–Майера и log-rank-теста. Биохимический рецидив определяли как повышение уровня простатспецифического антигена t 0,2 нг / мл в 2 последовательных измерениях или как начало адъювантной терапии.

Результаты. Частота обнаружения положительного хирургического края снизилась с 55,9 % в 1997–2006 гг. до 37,9 % в 2007– 2012 гг. (p = 0,01); безрецидивная выживаемость через 5 лет составила 38,8 % против 66,2 % (p < 0,001).

Выводы. Данные изменения, вероятно, могут являться следствием улучшения опыта хирургов и усовершенствования хирургической техники с течением времени

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