局灶射頻消融治療低危與中危局限性前列腺癌的療效分析

Efficacy of focal radiofrequency ablation in the treatment of low-to-intermediate risk localized prostate cancer

GAO Shu，JIANG Zhen，SUN Jiyuan，HUANG Haifeng，ZHANG Qing，GUO Hongqian

（Department of Urology，Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University，Nanjing 210000，China）

ABSTRACT：Objective To explore the efficacy of focal radiofrequency ablation （RFA） in the treatment of low-to-intermediate risk localized prostate cancer and its impact on postoperative urinary control and sexual function recovery，in order to explore the feasibility of minimally invasive methods for the treatment of localized prostate cancer.Methods Clinical data of 28 patients with low-to-intermediate risk localized prostate cancer who underwent RFA in Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School during Jun.2017 and Feb.2021 were retrospectively analyzed.The 5-year failure-free survival （FFS） rate，surgery related complications，postoperative urinary control and sexual function were collected.The differences between the survival curves of patients in the low-risk and intermediate-risk subgroups were assessed with log-rank test and Breslow test.Results All surgeries were successfully completed under local anesthesia.During the median follow-up of 43 （40-49） months，the 5-year FFS rate predicted by Kaplan-Meier method was 78.57%; 25 patients （89.29%） did not experience surgery-related complications; 27 patients （96.43%） were able to control urination; 1 patient developed new-onset sexual dysfunction.There was no significant difference in the survival curves between patients in the low-risk and intermediate-risk groups （P＞0.05）.Conclusion RFA for patients with low-to-intermediate risk localized prostate cancer has good clinical efficacy，little impact on urinary control and sexual function recovery，and few postoperative complications，which can be used as one of the treatment options for these patients.

KEY WORDS：focal radiofrequency ablation; prostate cancer; low-to-intermediate risk; localized; failure-free survival rate；urinary control；sexual function

摘要：目的 探討局灶射頻消融（RFA）治療低危與中危局限性前列腺癌的療效及其對患者術后尿控和性功能恢復的影響，以期探究微創方法治療局限性前列腺癌的可行性。方法 回顧性分析2017年6月—2021年2月南京大學醫學院附屬鼓樓醫院接受RFA治療的28例低危與中危局限性前列腺癌患者的臨床資料，統計分析患者的5年無失敗生存（FFS）率、手術相關并發癥、術后尿控及性功能情況。采用log-rank檢驗和Breslow檢驗評估低危與中危分組患者生存曲線間的差異。結果 所有手術均在局部麻醉下順利完成。中位隨訪時間43（40～49）個月，隨訪期內所有患者均存活，采用Kaplan-Meier法預測的5年FFS率為78.57%。25例（89.29%）患者未出現手術相關并發癥，27例（96.43%）患者術后可以自主控尿。1例患者術后出現新發性功能障礙。低危組與中危組患者間生存曲線差異無統計學意義（Pgt;0.05）。結論 局灶RFA治療低危與中危局限性前列腺癌患者臨床療效較好，對尿控及性功能的影響小且術后并發癥較少，是該類患者的可選治療方案。

關鍵詞：局灶射頻消融；前列腺癌；低危與中危；局限性；無失敗生存率；尿控；性功能

中圖分類號：R737.25 文獻標志碼：ADOI：10.3969/j.issn.1009-8291.2025.02.010

收稿日期：2024-06-11 修回日期：2024-08-18

通信作者：郭宏騫，主任醫師，教授。E-mail：drghq@nju.edu.cn;

張青，副主任醫師，副教授。E-mail：drzhangq@nju.edu.cn

作者簡介：郜澍，碩士研究生。研究方向：泌尿腫瘤的微創治療。

E-mail：njushugao@qq.com

前列腺癌（prostate cancer，PCa）是全世界范圍內男性發病率排名第2的腫瘤，也是男性腫瘤相關性死亡的第5大原因^［1］。低危與中危前列腺癌患者在選擇治療方案時，需綜合評估腫瘤控制和功能學恢復獲益情況。……