Radical Prostatectomy Intraoperative Photodynamic Control

Chernyshev I.V., Zhernov A.A., Altunin D.V., Kallaev K.K.

At present time radical prostatectomy (RPE) remains one of the most common option of prostate cancer (PCa) surgical treatment. Oncologic specific survival rate is the main criteria of surgical treatment efficiency. One of the factors that can influence on this rate is positive surgical margin that indicates the presence of residual tumor tissues. Due to aforementioned the challenge of intraoperative control methods development is very actual. Fluorescent diagnostics can be considered the possible one. 40 patients were included into research. All these patients underwent radical surgical treatment of prostate cancer in a period of January February 2010. 24 patients (60%) underwent laparoscopic (extraperitonescopic) RPE and 16 (40%) underwent open RPE. Age range was 53 73 (60±13.4), PSA range was 2.3 50.0 ng/ml (26.5±13.4), Gleason score 5 to 9. Home-produced photosensitizer "Alasens" (5aminolevulinic acid) in dose 20 mg per 1 kg of weight was used. Photosensitizer was took orally in one hour before surgery. Intraoperatively images of prostate gland in blue and white light were received. Results of fluorescent diagnostics were confirmed by histological investigation. The result was correct (negative or positive) in 82.5% of general group cases, in 87.5% of laparoscopic cases, 74.9% of open cases. Sensibility of method for general group was 90%, laparoscopic group 73%, open surgery group 35%. Specificity was 52%, 86% and 100% respectively.

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