The Building Of RRP Patients’ Clinical Database And Analysis Of Data

Background: It can be seen that there is a high incidence of prostate cancer inthe European and American countries. It is the second leading cause of malemalignant tumor death in the United States, Its incidence in male malignant tumorranks the first. In recent years, the incidence of prostate cancer in China is obviouslyrise trend. According to Shanghai malignant tumor incidence statistics show, itsincidence has risen to the sixth in male malignant tumor until2007. Radicalprostatectomy is one of the most important methods for the treatment of early prostatecancer, Prostate cancer has differences in clinical manifestation, auxiliary examinationmeans and preoperative treatment, etc. To carry out large-scale data collection, sortingand analysis, and then proceed prospective studies according to the data analysis, Weneed to have a more complete prostate cancer database management system. So it canbe convenient to the statistical data for further research.Objective: Exploration and set up the database of prostate cancer to facilitatethe collection, management, and query of the prostate cancer patient data. We conducta post-operation follow-up to the patients we have statistics, to know their recovery ofpostoperative urinary control and sexual function. Analyze their preoperative andpostoperative follow-up information, we hope to find more about the factors that isrelate to the recovery after the prostatectomy, and then apply to our clinic.Methods: According to the actual situation needs, using the LianZhongResearch Center, we collect the clinical data of the patients who accept the radicalprostatectomy during February,2009to October,2012. And we conduct apostoperative follow-up to these patients, mainly for the information of tumorrecurrence, postoperative urinary control and erectile function. We retrospective study these datas, hoping to find more correlative factors between radical prostatectomy andthe recovery after the prostatectomy.Results:1) There are134cases we can get the pathological diagnosis, duringwhich there are29cases which surgical margins or seminal vesicle, obturator lymphnodes are positive. During these29cases there are21which Gleason score are7(22.6%), there are4cases which Gleason score are8(40%), there are4whichGleason score are9(57.1%), on the other side, in the rest of the cases which surgicalmargins or seminal vesicle, obturator lymph nodes are negative, there are24whichGleason score are6, there are72which Gleason score are7, there are6whichGleason score are8, there are3which Gleason score are9.2) During the29cases, there are8cases whose urethra stumps are positive alone,there are5cases whose circumferential resection margins are positive alone, there are4cases whose seminal vesicles are positive alone, there are2cases whose obturatorlymph nodes are positive alone, there are4cases whose urethra stumps andcircumferential resection margins are both positive, there are2cases whose urethrastumps and seminal vesicles are both positive, there is1case whose circumferentialresection margins and seminal vesicles are both positive, there are2cases whoseseminal vesicles and obturator lymph nodes are both positive. There is1case whoseurethra stumps, circumferential resection margins and seminal vesicles are all positive.That is to say, there are15cases whose urethra stumps are positive in total（51.7%）,there are11cases whose circumferential resection margins are positive in total（37.9%）, there are10cases whose seminal vesicles are positive in total（34.4%）,there are4cases whose obturator lymph are positive in total（13.8%）.3) There are132cases which have both Gleason scores before and after theoperation， during these cases, there are60cases whose Gleason scores areinconformity. There are10cases whose scores are discrepancy for2point while thereare50cases whose scores are discrepancy for1point.4) The statistics of the positiveneedles are89in total. There are36cases whose percentages of positive needles arenot in excess of33.3%. There are53cases whose percentages of positive needles arein excess of33.3%. Postoperative cut edge: There are3cases whose percentages of positive needles are not in excess of33.3%(8.3%), there are14cases whosepercentages of positive needles are in excess of33.3%(26.4%).5) There are94follow-up visit patients,5have been dead: carcinoma of sigmoid accompany hepaticmetastases, primary lung cancer, senile dementia, lung metastases and dysoemia.6)Urinary control’s follow-up visit after BNSRRP: there are85patients in total, thereare31patients who have urine leakage, in more details, there are16cases whosesubjective scoring are above3. During them,5have been suffered radiotherapy,1lymphatic fistula appear and drain for34days,2are just4months after RRP,1urinary fistula occur and drain for22days,1biochemical recurrence appear andgiven the endocrinotherapy,1person has positive urethra stump.Conclusion: The establishment of prostate cancer database management systemprovides a good platform for the clinic and fundamental research of PCA. After moreimprovement, it can have positive meaning along with follow-up visit content. In allthe clinical data of prostate cancer patient, there is no significant positive impact ofGleason score to the positive surgical margin of patient with prostate cancerunderwent radical resection. Positive percentage of the needle biopsy has significantimpacts on positive surgical margins. The consistency of prostate biopsy specimenand radical cure specimens are not so good. Most of the time, the score of biopsyspecimen are lower than radical cure specimens. Total PSA was significantlypositively correlated with Gleason score. There is no significant positive impact ofurinary fistula to the positive surgical margin of patient with prostate cancerunderwent radical resection, but it may have close relations with radiotherapy.