Objective To investigate the safety and effectiveness of open radical prostatectomy (ORP) for locally advanced prostate cancer (LAPC).Methods From January 2012 to April 2017,132 cases underwent ORP were included.The mean age was 65.1 years old (ranged 41 to 83 years old),median PSA was 28.9 ng/ml (ranged 1.2 to 319.7 ng/ml) and mean Glcason score was 8.0(ranged 6.0 to 10.0).The number of clinical stage T3aN0,T3bN0,T4N0 and T1 ～4N1 were 92 cases(69.7％),20 cases (15.2％),8 cases (6.1％) and 12 cases (9.0％),respectively.Results The median length of hospital day,mean operative time and median blood loss were 9 d,180 min and 350 ml respectively.The intraoperative complication rate was 3.0％ (4/132),including 2 rectum injury and 2 iliac vessel injury.Pathological tumor stage revealed that ≤ pT2 N0 7 cases (5.3％),pT3a N0 61 cases (46.2％),pT3b N0 38 cases (28.8％),pT4N0 12 cases (9.1％) and pT1～4N1 14 cases (10.6％).The mean Gleason score was 8.0 (ranged 6 tol0).The numbers of patients with perineural invasion,seminal vesicle invasion and positive surgical margin were 81 cases (61.4％),49 cases (37.1％) and 41 cases (31.1％) respectively.The median follow-up duration was 24.1 (ranged 1.8 to 62.2) months.The rate of postoperative complications was 3.0％ (4/132) including 1 urethral stricture,1 wound infection,1 intestinal fistula and 1 lymphatic fistula.The rates of patients with urinary continence 1,3,6 and 12 months after surgery were 30.4％ (38/125)、63.9％ (76/119)、72.6％ (82/112)、89.1％ (90/101).The rates of adjuvant hormonal therapy and radiotherapy were 34.1％ (45/132) and 38.6％ (51/132).One patient (0.8％) died of lung cancer.The rate of biochemical recurrence(BCR) was 25.8％ (34/132).The 5-year BCRfree survival rate was 57.2％ (95％ CI 41.9％ ～ 70.6％).Conclusion The oncological control and functional recovery outcomes of ORP for locally advanced prostate cancer were reliable.

<正>前列腺癌是威胁男性健康的最常见肿瘤之一,在发达国家其发病率居男性肿瘤首位,占全部恶性肿瘤的28%;其死亡率仅次于肺癌[1]。前列腺癌的发病率和死亡率具有明显的种族差异,我国前列腺癌的发病率和死亡率虽远低于欧美国家,但近年来随着人口老龄化及生活条件的改善,其发病率呈快速上升的趋势。上海地区前列腺癌的发病率已从1990年的2.6/10万上升至2005年的16.1/10万,超过膀胱癌成为泌尿系统最常见的恶性肿瘤。从分子遗传学角度来看,前列腺癌的发生、发展是一个多因素、多阶段的过程,往往涉及多个基因的改变。近年来,随着人类基因组学、蛋白质组

Objective:To evaluate the safety and effectiveness of transurethral resection of prostate(TURP) in senior high risk patients with benign prostatic hyperplasia(BPH).Methods:A total of 138 patients,all aged over 80 years,with benign prostatic hyperplasia underwent TURP in our institution.The average operation time was (40±3)min,range:30-60 min.No transurethral resection syndrome or massive bleeding occurred during the operation.Results:All patients were followed up for 3 to 72 months,mean:(16±2)months.The International Prostate Symptom Score(SPSS) decreased from 21.5±6.9 to 9.3±4.2,Quality of Life(QOL) from 5.5±1.4 to 3.1±0.5 and postvoid residual volume(PVR) from (160±5)ml to (25±1.5)ml,whereas maximum urinary flow-rate increased from (6.8±1.3)ml/s to (17.8±2.5)ml/s.All differences were statistically significant(P<0.05).Postoperatively,all patients had fluent urination.No further damage to heart,brain,liver,kidney or other systems were observed in any patient.Conclusion:Performed by an experienced urologist with proper perioperative management,TURP is a safe and effective treatment modality in senior high risk patients.