Efficacy of laparoscopic surgery for elderly patients with prostate cancer and influencing factors of biochemical recurrence
Objective To evaluate the application efficay of different approaches of laparoscopic surgery in the treatment of prostate cancer(PCa)in the elderly and analyze the influencing factors for postoperative biochemical recurrence.Methods Clinical data of 164 elderly PCa patients undergoing laparoscopic radical prostatectomy in our hospital from January 2019 to June 2021 were collected,and 88 cases of them received bladder anterior approach treatment(anterior approach group)and 76 cases with bladder posterior approach(posterior approach group).Perioperative indicators,complications and postoperative biochemical recurrence were compared between two groups.SPSS statistics 24.0 was used for statistical analysis.Data comparison between two groups was performed using student's t test or Chi-square test depending on data type.Log Rank test was applied to analyze the survival time of non-biochemical recurrence.Logistic regression analysis was conducted to identify the influencing factors for biochemical recurrence after laparoscopic radical prostatectomy in elderly PCa patients.Results The operation time,duration of urinary catheter retention and length of hospital stay were significantly shorter in the anterior approach group than the posterior approach group(P<0.05).There were no statistical differences in the total incidence rate of complications and the survival time of non-biochemical recurrence between two groups(P>0.05).Logistic regression analysis showed that preoperative prostate specific antigen(PSA)≥10.0 μg/L(OR=2.924,95%CI 1.753-4.877),postoperative Gleason score>7 points(OR=3.068,95%CI 1.852-5.081)and positive surgical margin(OR=2.547,95%CI 1.417-4.578)were risk factors of biochemical recurrence after laparoscopic radical prostatectomy(P<0.05).Conclusion Bladder anterior approach in laparoscopic radical prostatectomy is more conducive to postoperative recovery and has shorter surgical time for elderly PCa patients.The patients with high preoperative PSA level,high postoperative Gleason score and positive surgical margin are more prone to biochemical recurrence,and should be closely monitored in clinical practice.
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