【摘要】 目的:基于真实世界临床数据，评估机器人辅助前列腺癌根治术(robot-assisted radical prostatectomy, RARP)联合内分泌治疗寡转移性前列腺癌(oligometastatic prostate cancer, OmPCa)的安全性及疗效。方法:回顾性分析2010年3月—2022年12月于中国人民解放军总医院第一医学中心、第三医学中心、第六医学中心、南昌大学第一附属医院以及苏州大学第一附属医院接受RARP治疗的OmPCa患者的临床资料。分析内容包括患者的围手术期结局、术后功能结局和肿瘤学结局。结果:共纳入100例患者，中位手术时间为156(120,190) min,中位术中出血量为100(60,110) mL,术后中位住院时间为5(4,7) d。术后30 d内并发症发生率为5.0%。术后第1、3和12个月的尿失禁恢复率分别为67.1%、82.3%和96.2%。术后1年，95.0%的患者存在勃起功能障碍。18例患者发现阳性手术切缘。中位随访时间为49(32,69)个月。90例患者前列腺特异性抗原(prostate-specific antigen, PSA)降至根治水平，所有患者达到最低PSA的中位时间为3(1,3)个月。中位生化无进展生存期(biochemical progression-free survival, bPFS)为47(37,57)个月，中位影像学无进展生存期(radiological progression-free survival, rPFS)为55(46,64)个月。3年bPFS率、rPFS率、去势抵抗无进展生存(castration-resistant progression-free survival, crPFS)率和总生存(overall survival, OS)率分别为60.3%、66.5%、81.9%和92.9%。结论:在真实世界中国人群中，RARP联合内分泌治疗OmPCa安全可行，能够在实现较好围手术期结局和可接受的术后功能保留的基础上，为患者提供较为长期的生存获益。更多还原

【Abstract】 Objective: To evaluate the safety and efficacy of robot-assisted radical prostatectomy(RARP) combined with endocrine therapy for oligometastatic prostate cancer(OmPCa) based on real-world clinical data. Methods: Clinical data of patients with OmPCa who underwent RARP between March 2010 and December 2022 were retrospectively collected from the First, Third, and Sixth Medical Centers of Chinese PLA General Hospital, the First Affiliated Hospital of Nanchang University, and the First Affiliated Hospital of Soochow University. Analyzed contents included perioperative outcomes, postoperative functional outcomes, and oncological outcomes. Results: A total of 100 patients were enrolled. The median operative time was 156(120, 190) min, the median intraoperative blood loss was 100(60, 110) mL, and the median postoperative hospital stay was 5(4, 7) days. The complication rate within 30 days postoperatively was 5.0%. The urinary continence recovery rates at 1, 3, and 12 months postoperatively were 67.1%, 82.3%, and 96.2%, respectively. At 1 year postoperatively, 95.0% of patients had erectile dysfunction. Positive surgical margins were found in 18 patients. The median follow-up time was 49(32, 69) months. Prostate-specific antigen(PSA) levels decreased to the radical level in 90 patients. The median time to reach nadir PSA for all patients was 3(1, 3) months. The median biochemical progression-free survival(bPFS) was 47(37, 57) months, and the median radiological progression-free survival(rPFS) was 55(46, 64) months. The 3-year bPFS rate, rPFS rate, castration-resistant PFS(crPFS) rate, and overall survival(OS) rate were 60.3%, 66.5%, 81.9%, and 92.9%, respectively. Conclusion: In a real-world Chinese population, RARP combined with endocrine therapy for OmPCa is safe and feasible, and while achieving favorable perioperative outcomes and acceptable postoperative functional preservation, it can provide patients with a relatively long-term survival advantage.更多还原