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Asian Journal of Andrology 2022年第5期24卷 487-493页

作者： Xing Li Zhi-Xian Wang Yun-Peng Zhu Jing Wang Yi-Sheng Yin Xiao-Yong Zeng Department of Urology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

We performed this study to investigate pathological upgrading from biopsy to prostatectomy and clinicopathological factors associated with grade group(GG)upgrading in patients with International Society of Urological Pathology(ISUP)GG 1 and 2 prostate cancer(PCa)in a Chinese cohort.We included patients diagnosed with PCa with ISUP GG 1 and 2 at biopsy,who underwent RP at our institution.Pre-and postoperative clinical variables were examined.Univariate and multivariate logistic regression analyses were conducted to identify independent factors associated with GG upgrading.Patients in GG upgraded group had higher total prostatespecific antigen(tPSA;median:14.43 ng ml^(−1) vs 10.52 ng ml^(−1),P=0.001)and PSA density(PSAD;median:0.45 ng ml^(−2) vs 0.27 ng ml^(−2),P3(86.4%vs 67.9%,P3(odds ratio[OR]:2.471,95%confidence interval[CI]:1.132–5.393;P=0.023),higher PSAD(P=0.001),and GG in biopsy(OR:0.241,95%CI:0.123–0.471;P3,and PNI were independent factors of GG upgrading.These factors should be considered for patients with ISUP grade≤2 PCa.

关键词： biopsy grade group prostate cancer radical prostatectomy upgrading

Robot-assisted oncologic pelvic surgery with Hugo™robot-assisted surgery system:A single-center experience

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Asian Journal of Urology 2023年第4期10卷 461-466页

作者： Angelo Territo Alessandro Uleri Andrea Gallioli Josep Maria Gaya Paolo Verri Giuseppe Basile Alba Farré Alejandra Bravo Alessandro Tedde Óscar Rodríguez Faba Joan Palou Alberto Breda Department of Urology FundacióPuigvertAutonomous University of BarcelonaBarcelonaSpain

Objective To report the outcomes of intra-and extra-peritoneal robot-assisted radical prostatectomy(RARP)and robot-assisted radical cystectomy(RARC)with Hugo™robot-assisted surgery(RAS)system(Medtronic,Minneapolis,MN,USA).Methods Data of twenty patients who underwent RARP and one RARC at our institution between February 2022 and January 2023 were reported.The primary endpoint of the study was to report the surgical setting of Hugo™RAS system to perform RARP and RARC.The secondary endpoint was to assess the feasibility of RARP and RARC with this novel robotic platform and report the outcomes.Results Seventeen patients underwent RARP with a transperitoneal approach,and three with an extraperitoneal approach;and one patient underwent RARC with intracorporeal ileal conduit.No intraoperative complications occurred.Median docking and console time were 12(interquartile range[IQR]7-16)min and 185(IQR 177-192)min for transperitoneal RARP,15(IQR 12-17)min and 170(IQR 162-185)min for extraperitoneal RARP.No intraoperative complications occurred.One patient submitted to extraperitoneal RARP had a urinary tract infection in the postoperative period that required an antibiotic treatment(Clavien-Dindo Grade 2).In case of transperitoneal RARP,two minor complications occurred(one pelvic hematoma and one urinary tract infection;both Clavien-Dindo Grade 2).Conclusion Hugo™RAS system is a novel promising robotic platform that allows to perform major oncological pelvic surgery.We showed the feasibility of RARP both intra-and extra-peritoneally and RARC with intracorporeal ileal conduit with this novel platform.

关键词： Bladder cancer Prostate cancer radical cystectomy radical prostatectomy Robotic surgery

Prospective and long-term evaluation of erect penile length obtained with inflatable penile prosthesis to that induced by intracavernosal injection

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Asian Journal of Andrology 2009年第4期11卷 411-416页

作者： Run Wang Galen E Howard Anthony Hoang Jiu-Hong Yuan Hao-Cheng Lin Yu-Tian Dai Division of Urology University of Texas Medical School at Houston TX 77030 USA Department of Urology University of Texas MD Anderson Cancer Center Houston TX 77030 USA Department of Urology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing 210008 China

We compared erect penile length after inflatable penile prosthesis （IPP） implantation with that induced by intracavemosal injection （ICI） before surgery. A total of 11 patients with full erections induced by ICI of 0.25 mL of Trimix （papaverine, phentolamine and prostaglandin E 1） at the time of penile color duplex Doppler ultrasonograpby were enrolled in this study. The patients subsequently underwent IPP implantation as the ultimate treatment for their erectile dysfunction （ED）. Erect penile length consequent to IPP implantation was measured at 6 weeks, 6 months and at I year after surgery. The Sexual Health Inventory for Men （SHIM） was administered before, and at 6 months and 1 year after IPP implantation. Erect penile length （mean ± s.c.） as induced by ICI was 13.2 ± 0.4 cm, whereas the lengths attained with IPP were 12.4 ± 0.3, 12.5 ± 0.3 and 12.5 ± 0.4 cm at the sixth week, sixth month and 1-year follow-ups, respectively. There were 0.83 ± 0.25, 0.75 ± 0.20 and 0.74 ± 0.15 cm decreases in erect penile length at 6 weeks, 6 months and 1 year, respectively, after IPP implantation when compared with that after ICI （P 〈 0.05）. The SHIM scores for patients reporting shorter penises were the same as those for patients without complaints at the 6-month and 1-year follow-ups （P 〉 0.05）. To our knowledge, this is the first study to objectively show a significant decrease in erect penile length after IPP implantation when compared with that after ICI. However, this decrease did not affect the effectiveness of IPP in treating ED.

关键词： erectile dysfunction intracavemosal injection length penile prosthesis radical prostatectomy

Emerging neuromodulatory molecules for the treatment of neurogenic erectile dysfunction caused by cavernous nerve injury

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Asian Journal of Andrology 2008年第1期10卷 54-59页

作者： Anthony J. Bella Guiting Lin Ilias Cagiannos Tom F. Lue Department of Surgery Division of UrologyUniversity of Ottawa Ottawa KIY4E9 Canada Department of Neuroscience Ottawa Health Research Institute University of Ottawa Ottawa KIY4E9 Canada Knuppe Molecular Urology Laboratory San Francisco CA 94143 USA Department of Urology University of California San Francisco CA 94143 USA

Advances in the neurobiology of growth factors, neural development, and prevention of cell death have resulted in a heightened clinical interest for the development of protective and regenerative neuromodulatory strategies for the cavernous nerves （CNs）, as therapies for prostate cancer and other pelvic malignancies often result in neuronal damage and debilitating loss of sexual function. Nitric oxide released from the axonal end plates of these nerves within the corpora cavernosa causes relaxation of smooth muscle, initiating the haemodynamic changes of penile erection as well as contributing to maintained tumescence; the loss of CN function is primarily responsible for the development of erectile dysfunction （ED） after pelvic surgery and serves as the primary target for potential neuroprotective or regenerative strategies. Evidence from pre-clinical studies for select neuromodulatory approaches is reviewed, including neurotrophins, glial cell line-derived neurotrophic factors （GDNF）, bone morphogenic proteins, immunophilin ligands, erythropoetin （EPO）, and stem cells.

关键词： erectile dysfunction prostate cancer radical prostatectomy postoperative complications neuroprotection nerve regeneration neurotrophins brain-derived nerve growth factor immunophilin ligands stem cells

Risk of complications and urinary incontinence following cytoreductive prostatectomy： a multi-institutional study

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Asian Journal of Andrology 2018年第1期20卷 9-14页

作者： Dae Keun Kim Jaspreet Singh Parihar Young Suk Kwon Sinae Kim Brian Shinder Nara Lee Nicholas Farber Thomas Ahlering Douglas Skarecky Bertram Yuh Nora Ruel Wun-lae Kim Koon Ho Rha Isaac Yi Kim Department of Urology CHA Seoul Station Medical Center CHA University CHA Medical School Seou104637 Korea Department of Urology School of Medicine Graduate School Hanyang University Seou104763 Korea Section of Urologic Oncology Rutgers Cancer Institute of New Jersey and Division of Urology Rutgers Robert Wood Johnson Medical School Rutgers The State University of New Jersey New Brunswick 08901 USA Department of Biostatistics Rutgers School of Public Health The State University of New Jersey New Brunswick NJ Piscataway 08854 USA Department of Internal Medicine Rutgers Robert Wood Johnson Medical School Rutgers The State University of New Jersey New Brunswick 08901 USA Department of Urology University of California Irvine School of Medicine Orange 92687 USA Division of Urology and UroLogic Oncology City of Hope National Medical Center Duarte 91010 USA Department of Urology Chungbuk National University College of Medicine Cheongju 28644 Korea Department of Urology and Urological Science Institute College of Medicine Yonsei University Seou103722. Korea

Emerging evidence has suggested that cytoreductive prostatectomy （CRP） allows superior oncologic control when compared to current standard of care androgen deprivation therapy alone. However, the safety and benefit of cytoreduction in metastatic prostate cancer （mPCa） has not been proven. Therefore, we evaluated the incidence of complications following CRP in men newly diagnosed with mPCa. A total of 68 patients who underwent CRP from 2006 to 2014 at four tertiary surgical centers were compared to 598 men who underwent radical prostatectomy for clinically localized prostate cancer （PCa）. Urinary incontinence was defined as the use of any pad. CRP had longer operative times （200 min vs 140 min, P 〈 0.0001） and higher estimated blood loss （250 ml vs 125 ml, P 〈 0.0001） compared to the control group. However, both overall （8.82% vs 5.85%） and major complication rates （4.41% vs 2.17%） were comparable between the two groups. Importantly, urinary incontinence rate at 1-year after surgery was significantly higher in the CRP group （57.4% vs 90.8%, P 〈 0.0001）. Univariate logistic analysis showed that the estimated blood loss was the only independent predictor of perioperative complications both in the unadjusted model （OR： 1.18; 95% Ch 1.02-1.37; P= 0.025） and surgery type-adjusted model （OR： 1.17; 95% Ch 1.01-1.36; P= 0.034）. In conclusion, CRP is more challenging than radical prostatectomy and associated with a notably higher incidence of urinary incontinence. Nevertheless, CRP is a technically feasible and safe surgery for selecting PCa patients who present with node-positive or bony metastasis when performed by experienced surgeons. A prospective, multi-institutional clinical trial is currently underway to verify this concept.

关键词： cytoreductive surgical procedures metastatic prostate cancer outcome radical prostatectomy

Outcomes of locally advanced prostate cancer:a single institution study of 209 patients in Japan

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Asian Journal of Andrology 2006年第5期8卷 555-561页

作者： ToshihiroSaito YasuoKitamura ShuichiKomatsubara YasuoMatsumoto TadashiSugita Noboru Hara Department of Urology Niigata Cancer Center Hospital Niigata 951-8566Japan Radiotherapy Niigata Cancer Center HospitalNiigata 951-8566Japan Department of Urology Niigata Cancer Center Hospital Niigata 951-8566Japan Division of Urology Department of Regenerative and Transplant MedicineGraduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan

Aim： To investigate the outcomes for Asian populations with locally advanced/clinical stage Ⅲ prostate cancer （PCa） treated with currently prevailing modalities. Methods： We reviewed the record of 209 patients with clinical stage Ⅲ PCa, who were treated at Niigata Cancer Center Hospital between 1992 and 2003. Treatment options included hormone therapy-combined radical prostatectomy （RP＋HT）, hormone therapy-combined external beam irradiation （EBRT＋HT） and primary hormone therapy （PHT）. Results： The 5- and 10-year overall survival rates were 80.3% and 46.1% in all cohorts, respectively. The survival rates were 87.3% and 66.5% in the RP＋HT group, 94.9% and 70.0% in the EBRT＋HT group and 66.1% and 17.2% in the PHT group, respectively. A significant survival advantage was found in the EBRT＋HT group compared with that in the PHT group （P 〈 0.0001）. Also, the RP＋HT group had better survival than the PHT group （P = 0.0107）. The 5- and 10-year disease-specific survival rates for all cases were 92.5% and 80.0%, respectively. They were 93.8% and 71.4% in the RP＋HT group, 96.6% and 93.6% in the EBRT＋HT group and 88.6% and 62.3% in the PHT group, respectively. A survival advantage was found in the EBRT＋HT group compared with the PHT group （P = 0.029）. No significant difference was found in disease-specific survival between the EBRT＋HT and RP＋HT groups or between the RP＋HT and PHT groups. Condusion： Although our findings indicate that radiotherapy plus HT has a survival advantage in this stage of PCa, we recommend therapies that take into account the patients＇ social and medical conditions for Asian men with clinical stage Ⅲ PCa.

关键词： locally advanced prostate cancer radical prostatectomy radiotherapy hormone therapy

3omorbidity and survival of patients selected for radica prostatectomy at an age of 75 years or older

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Asian Journal of Andrology 2013年第5期15卷 667-671页

作者： Michael Froehner Rainer Koch Manfred P Wirth Departments of Urology University Hospital 'Carl Gustav Carus' Dresden University of Technology Dresden D-01307 Germany Department of Medical Statistics and Biometry University Hospital 'Carl Gustav Carus' Dresden University of Technology Dresden D-01307 Germany

radical prostatectomy in elderly patients is controversial. To identify very old candidates for radical prostatectomy with the highest probability of long-term survival, we studied 47 consecutive men who underwent radical prostatectomy between 1992 and 2005 at an age of 75 years or older. A heuristic approach was used to search for subgroups with particularly high long-term survival. Several two-sided comorbidity measures and combinations of these measures were investigated to find classifications best identifying healthy, long-living elderly candidates for radical prostatectomy. Four of the 25 two-sided comorbidity classifications or combinations reached the significance level with hazard ratios between 4.00 and 4.80. After 10 years, patients identified as healthy patients according to these comorbidity measurements had exhibited relative survival rates between 129% and 137% and overall survival rates between 86% and 95%, whereas those with comorbidities had exhibited relative survival rates of only 66%-84% and overall survival rates of 44%-58%. In conclusion, classifying comorbidity may identify a meaningful proportion of men selected for radical prostatectomy at an age of 75 years or older with an excellent long-term survival probability superseding that of the general population.

关键词： comorbidity old age overall survival prostate cancer radical prostatectomy relative survival

Updated results from the European Randomized Study of Prostate-Specific Antigen （PSA） Screening for Prostate Cancer： are Asian countries encouraged to promote PSA screening？

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Asian Journal of Andrology 2012年第4期14卷 522-524页

作者： Mikio Sugimoto Yoshiyuki Kakehi Department of Urology Kagawa University Faculty of Medicine Kita-gun Kagawa 761-0793 Japan

An updated result of European Randomized Screening Trial for Prostate Cancer encourages Asian countries to proceed prostate-specific antigen （PSA） screening for early detection. On the other hand, the issue of overtreatment is emerging as a serious problem. Active surveillance （AS） should be more prevalent than now to avoid overtreatment for patients with favourablerisk prostate cancer （PCa） detected by PSA test.

关键词： ACTIVE SURVEILLANCE radical prostatectomy MORTALITY FUSION TRIAL MEN

Robotic surgery in giant multilocular cystadenoma of the prostate:A rare case report

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World Journal of Clinical Cases 2020年第18期8卷 4215-4222页

作者： Le-Wei Fan Ying-Hsu Chang I-Hung Shao Kuei-Fang Wu See-Tong Pang Division of Urology Department of SurgeryChang Gung Memorial HospitalTaoyuan 333Taiwan Department of Pathology Chang Gung Memorial HospitalTaoyuan 333Taiwan

BACKGROUND Giant multilocular cystadenoma(GMC)of the prostate gland is a very rare benign tumor.Although the benign nature has been known,complete surgical excision is the major treatment consensus because of its high recurrence rate.We report a rare case of GMC with accompanying lower urinary tract symptoms and repeated urine retention initially thought to be symptoms of benign prostatic hyperplasia,which was treated with robot-assisted laparoscopic radical prostatectomy.CASE SUMMARY A 65-year-old man presented with a 2-year history of lower urinary tract symptoms that had deteriorated gradually within the previous six months,even though he had received treatment with a selective alpha-blocking agent.He had undergone two transurethral resections of the prostate(TURP)at a local hospital during a 4-mo interval because initial ultrasound imaging and prostatic core needle biopsy showed benign prostate hyperplasia.Upon the third recurrence,the patient underwent TURP with a green-light laser at our institution.The diagnosis was a tumor composed of variously sized dilated glandular and cystic structures lined by blended prostatic type epithelia positive for prostate-specific antigen;the final diagnosis was giant multilocular cystadenoma.Magnetic resonance imaging showed a large multilocular retrovesical mass 8.0 cm×7.3 cm×6.4 cm,with heterogeneous enhancement.A coexisting malignant part could not be excluded.Considering the high recurrence rate,risk of coexisting malignancy,and possible sequelae of open surgery for radical excision,the patient decided to undergo robot-assisted radical prostatectomy,with good outcomes at the 2-year follow-up.CONCLUSION Robot-assisted surgery for the treatment of prostate GMC provides another choice for simultaneous attention to disease-control and postoperative quality of life.

关键词： Giant multilocular cystadenoma Prostate gland Robotic surgery radical prostatectomy Continence and erectile function Case report

Implications of the prostate intervention versus observation trial （PIVOT）

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Asian Journal of Andrology 2012年第6期14卷 803-804页

作者： Oliver Sartor Departments of Medicine and Urology Tulane University School of Medicine New Orleans LA 70112 USA

PSA screening improves early detection of prostate cancer but can lead to overtreatment if all of these cancers are treated. The first randomized treatment study for men with PSA detected cancers has now been reported.

关键词： radical prostatectomy CANCER