Повышение радикальности хирургического лечения больных раком предстательной железы тема диссертации и автореферата по ВАК РФ 14.00.40, кандидат медицинских наук Новиков, Роман Владимирович

• Новиков, Роман Владимирович
• кандидат медицинских наук
• 0

Оглавление диссертации кандидат медицинских наук Новиков, Роман Владимирович

2.2.2.

2.2.3.

2.2.4. У.

2.2.5. Т

2.2.6. 2.2.7.

2.3. Гла!

3. РЕЗУЛЬТАТЫ ОБСЛЕДОВАНИЯ БОЛЬНЫХ,

ПЕРЕНЕСШИХ

3.2.1.

3.2.2.

3.2.3.

3.2.7.

ПОСЛЕ 4.1.

КЛДФ ЖФ ЛРПЭ МКОБ

МРТ-ЭК нлт пни

ППСА ПРИ ПСА ПХК нхк оппс

РПЖ РПЭ

ГРУЗИ

ПЕРЕЧЕНЬ УСЛОВНЫХ СОКРАЩЕНИЙ

Введение диссертации (часть автореферата) на тему «Повышение радикальности хирургического лечения больных раком предстательной железы»

Актуальность исследования В новом тысячелетии во всем мире отмечается ежегодный рост заболеваемости раком предстательной железы (РПЖ) (Данилова Т.В., 2002; Мерабишвили В.М., 2006; Аш G. et al., 2005; Jemal А. et al., 2006). Проводимые скрининговые урологические обследования мужского населения старше 50 лет позволяют выявить аденокарциному простаты на ранних стадиях, что способствует успешному выполнению радикального лечения, снижению летальности и увеличению продолжительности жизни (Smith R.A. et al, 2006). С тех пор как Р. Walsh и Р, Donker (1982) описали анатомию дорзального венозного комплекса (ДВК) и кавернозных нервов, радикальная простатэктомия (РПЭ) приобрела широкую популярность в лечении локализованньис форм РПЖ. Возможность сохранения эректильной функции после операции наряду со значительным снижением тяжести и частоты осложнений позволяет предлагать этот метод лечения большой группе пациентов. В связи с возросшей ролью РПЭ в лечении больных РПЖ усиливается интерес к причинам рецидива заболевания в послеоперационном периоде. Одной из основньк его причин считается наличие позитивно1Х) хирургического края (ПХК). Несмотря на общую тенденцию в снижении частоты позитивньк хирургических краев при радикальном хирургическом лечении, обусловленную смещением стадии РПЖ в сторону локализованных форм (преимущественно Tic) на момент постановки диагноза и улучшением оперативной техники, процент ПХК, ассоциированный с рТЗ остается на стабильно высоком уровне (Han М. et al., 2004; Djuvan В. et al., 2006). Наличие ПХК, достоверно повышает частоту послеоперационной прогрессии РПЖ. Из всех прогностических факторов рецидива заболевания только позитивный ХК может зависеть от способа выполнения операции и проведения неоадъювантной гормональной терапии (HAT). В этой связи важнейшее значение приобретают вопросы предоперационного прогнозирования статуса хирургического края. Это позволит снижать частоту ПХК за счет предоперационной андрогенной терапии и изменения стандартного хода РПЭ, направленного на повышение радикальности оперативного вмешательства. За последние годы за рубежом проведены ряд исследований, посвященных изучению взаимосвязи различных клинических признаков с обнаружением опухолевых клеток в крае резекции при РПЭ. Однако по данным иностранных авторов до сих пор нет четкого представления о возможности достоверное) прогноза ПХК, В отечественной литературе данные подсЛньж исследований практически отсутствуют. Следовательно, недостаточное освещение в отечественной и зарубежной литературе, а также большой клинический материал (около трехсот РПЭ) послужили основанием для проведения данного исследования. Цель исследования Повысить эффективность хирургического лечения больных раком предстательной железы путем определения прогностических оставления позитивного хирургического края в ходе факторов радикальной простатэктомии. Задачи исследования 1. Исследовать частоту, локализацию и основные характеристики позитивного хирургического края при радикальной позадилонной простатэктомии. 2. Выявить наиболее информативные признаки определения вероятности оставления позитивного хирургического края при радикальной позадилонной простатэктомии. 3. Разработать математическую модель прогнозирования хирургического края при радикальной позадилонной простатэктомии. Научная новизна исследования статуса В данной работе впервые исследованы закономерности взаимосвязей наиболее распространенных клинических критериев, полученньк при стандартном обследовании больных РПЖ с ПХК. Проведен статистический анализ сопоставимости клинических, лабораторных и инструментальных исследований у пациентов с ПХК и негативным хирургическим краем (НХК). Впервые предложена математическая модель для определения вероятности оставления ПХК при РПЭ, в которую входят патоморфологические показатели: сумма Глисона, число биопсийных столбиков с опухолью, инвазия опухоли в капсулу и периневральная инвазия (ПНИ). Практическая значимость исследования Выявлены наиболее значимые диагностические критерии, полученные при стандартном обследовании больных РПЖ, проведен статистический анализ их взаимосвязи со статусом хирургического края, удаленных предстательных желез. На основе наиболее значимых признаков разработана математическая модель выявления на дооперационном этапе вероятности ПХК при позадилонной РПЭ. На контрольной группе пациентов доказана эффективность предложенной формулы в определении вероятности ПХК. Положения, выносимые на защиту: 1. Определение вероятности ПХК на дооперационном этапе позволяет снизить частоту местного рецидива РШК за счет проведения гормональной HAT и выбора адекватной модификации выполнения РПЭ. 2. Для точности выявления вероятности ПХК при РПЭ необходимо учитывать уровень простатспецифического антигена (ПСА), наличие очаговых изменений при пальцевом ректальном (ПРИ) и ультразвуковом (УЗИ) исследованиях, сумму Глисона, число позитивных биопсийных столбиков, максимальный процент опухолевой ткани в биопсийном столбике, инвазию опухоли в капсулу и ПНИ. 3. Разработанная математическая модель комплексной оценки признаков позволяет в 89,8% случаев верно определить статус хирургического края при позадилонной РПЭ.

Заключение диссертации по теме «Урология», Новиков, Роман Владимирович

ВЫВОДЫ

ПРАКТИЧЕСКИЕ РЕКОМЕНДАЦИИ

Y = 1,85 - 2,48Х5 - 1,21Х6 - 0,12Х3 - 0,01Х2

Список литературы диссертационного исследования кандидат медицинских наук Новиков, Роман Владимирович, 0 год

1. Аксель Е.М. Заболеваемость злокачественными новообразованиями мочевьк и мужских половых органов в России в 2003 г. Онкоурология. -2005.-№1.-С.6-9.

2. Аничков Н.М., Плотникова Н.А. О морфологии и классификации опухолеподобных поражений и рака предстательной железы Арх. патологии. 2001. Т. 63, 5. 44-50.

3. Велиев Е.И., Петров СБ. Рак предстательной железы: диагностика и результаты хирургического лечения локализованных и местнораспространенных форм Русский медицинский журнал. 2001. Т. 9, 13/14. 564-567.

4. Велиев Е.И, Оптимизация хирургического лечения локализованных форм рака предстательной железы: Дис. док. мед. наук. СПб, 2003. 293 с.

5. Велиев Е.И., Петров СБ., Лоран О.Б. Частота и локализация позитивного хирургического края и его роль в прогнозировании рецидива рака предстательной железы Урология. 2004, 6. 19-21.

6. Данилова Т.В. Заболеваемость и смертность от злокачественных новообразований предстательной железы в России Материалы IX Всероссийской конференции онкологов «Гормональные опухоли»: Тез. Докл. СПб.: 2002. С 35-36.

7. Лопаткин Н.А., Мартов А.Г. Состояние и перспективы развития урологической помощи в Российской Федерации X Рос. Съезд урологов: Материалы. М.: Информполиграф, 2002. 5-26.

8. Матвеев Б.П. Клиническая онкоурология. М.: Вердана, 2003. 717 с.

9. Мерабишвили В.М. Онкологическая служба в Санкт-Петгербурге и районах города в 2005 году (экспресс информация Популяционного ракового регистра). СПб.: 2006. 16 с.

10. Мерабишвили В.М., Хансон К.П. Злокачественные новообразования в северо-западном федеральном округе России. СПб: Медицинская

11. Переверзев А.С., Коган М.И. Рак простаты. Харьков: Факт, 2004. 231 с. О.Петров С Б Хирургия предстательной железы. СПб: Издательство Сергея Ходова, 2004. 270 с.

12. Петров СБ., Ракул А. Положительный хирургический край при радикальной позадилонной простатэктомии: частота, прогностические факторы, медикаментозная профилактика Онкоурология. 2006. 1. с 40-44.

13. Пушкарь Д.Ю. Радикальная простатэктомия. М.: МЕД пресс-информ, 2002.-167 с.

14. Пушкарь Д.Ю., Говоров А.В. Оценка эффективности неоадъювантной гормональной терапии золадексом и касодексом перед радикальной простатэктомией Фарматека. 2004. 11. 13-15. П.Рассветаев А.В. Прогнозирование недержания мочи у больных после радикальной позадилонной простатэктомии: Дис. канд. мед. наук. СПб, 2003.-187 с.

15. Сивков А.В., Аполихин О.И. Рак предстательной железы X Рос. съезд урологов: Материалы. М.: Информполиграф, 2002. С, 351-371.

16. Харченко П.В. Диагностика лока1Шзованного рака предстательной железы: Дис.... канд. мед. наук. СПб, 2003. 165 с.

17. Юнкеров В.И. Основы математико-статистического моделирования и применения вычислительной техники в научных исследованиях. СПБ.: ВМедА,2000.-140с.

18. Юнкеров В.И., Григорьев С Г Математико-статистическая обработка данных медицинских исследований. СПб.: ВМедА, 2002. 267 с.

19. Ackerman D.A., Barry J.M., Wicklund R.A. et al. Analysis of risk factore associated with prostate cancer extension to the surgical margin and pelvic

20. Ahlering Т.Е., Eichel L., Edwards R.A. et al. Robotic radical prostatectomy: A technique to reduce pT2 positive margins Urology. 2004. Vol. 64, 6. P. 1224-1228.

21. Alaya A.G., Ro J.U., Babaian R. et al. The prostatic capsule: does it exist? Its importance in the staging and treatment of prostatic carcinoma Am. J. Surg. Pathol. 1989. V o l 13, 1. P 21-26.

22. Alsikafi N.F., Brendler C.B. Surgical modifications of radical retropubic prostatectomy to decrease incidence of positive surgical margins J. Urol. 1998.-Vol. 159,№»4.P. 1281-1285.

23. Anscher M.S., Robertson C.N., Prosnitz R. Adjuvant radiotherapy for pathologic stage T3/4 adenocarcinoma of the prostate: ten-year update Int. J. Radiat. Oncol. Biol. Phys. 1995. V o l 33, 1. -P.37-43.

24. Amauld V., Thomas A.S., Cheryl Y. et al. Modified extrafascial radical retropubic prostatectomy technique decreases fi-equency of positive surgical margins in T2 cancers 2 cm Eur. Urol. 2000. Vol. 38, N 1. P. 64-73. 28. Aus G., Abbou C.C, Bolla M. et a l EAU guidelines on prostate cancer Eur. Urol. 2005. Vol. 48, Suppl. 4. P. 546-551.

25. Barocas D.A., Han M., Epstein J.I. et al. Does capsular incisions at radical retropubic prostatectomy affect disease-free survival in otherwise organconfined prostate cancer Urology. 2001. Vol. 58, 5. P. 746-751.

26. Basler J., Figenshau R., Bullock A. et al. Does bladder neck sparing radical prostatectomy improve continence or compromise margins of resection J. Urol. 1994. Vol. 151, part 2. P. 255A, abstract 110.

27. Bastacky S.I., Walsh P.C., Epstein J.I. Reletionship between perineural tumor invasion on needle biopsy and radical prostatectomy capsular penetration in clinical stage В adenocarcinoma of the prostate Am. J. Surg. Pathol. 1993. V o l 17, 2 P 336-341.

28. Beard C.J., PropertK.J., RiekerP.P. et al. Complications after treatment with

29. Bianco F.J., Grignon D.J., Sakr W.A. et al. Radical prostatectomy with bladder neck preservation: impact of a positive margins Eur. Urol. 2003, Vol. 43, 5 P 461-466.

30. Blute M.L., Bostwick D.G., Bergstralgh E.J. et al. Anatomic site-specific positive margins in organ confined prostate cancer and its impact on outcome after radical prostatectomy Urology. 1997. Vol. 50, Xa 5. P. 733-739.

31. Blute M.L., Bergstralh E.J., locca A. et al. Use of Gieason score, prostate specific antigen, seminal vesicle and margin status to predict biochemical failure after radical prostatectomy J. Urol. 2001. Vol. 165, 1. P. 119125. Зб.ВоИа M., van Hoppel H., Collette L. et al. Posoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911) Lancet. 2005. Vol. 366, 4. P. 524-525.

32. Bonin S.R., Hanlon A.L., Lee W.R. et al. Evidence of increased failure in the treatment of prostate carcinoma patint who have perineural invasion treated with three-dimensional confonnal radiation therapy Cancer. 1997. Vol. 79,№l.-P.75-80.

33. Borboroglu P.G., Amling C.L. Correlation of positive prostate sextant biopsy locations to sites of positive surgical margins in radical prostatectomy specimens Eur. Urol. 2001. Vol. 39, N 1. P. 648-654.

34. BostwickD.G. Eveluating prostate needle biopsy: therapeutic and prognostic importance CA Cancer J. Clin. 1997. Vol. 47, 5. P. 297-319.

35. Bostwick D.G., Grignon D., Hammond E.H. et al. Prognostic factors in prostate cancer. College of American Pathologists Concensus Statement 1999//Arch. Pathol. Lab. Med. 2000. Vol. 124,№ 7 P 995-1000.

36. Bostwick D.G., Quian J., Civantos F. et al. Does finteride alter the pathology of the prostate and cancer grading Clin. Prostate Cancer. 2004. Vol. 2,

38. Prostate biopsy and optimization of cancer yield Eur. Urol. 2006. Vol. 49, 3. P. 415-417.

39. Bothe K., Braun P.M., Hautman S. et al. Nerve-sparing radical prostatectomy: a new method of intra-operative frozen section analysis Eur. Urol. 2006. Vol. 5, suppl. 2. P. 321, abstract 1194.

40. Bott S.R., Freeman A.A., Stenning S. et al. Radical prostatectomy; pathology findings in 1001 cases compared with other major series and over time B.J.U. Int. 2005. Vol. 95, 1. P. 34-39.

41. Braslis K.G., Petsch M., Lim A. et al. Bladder neck preservation following radical prostatectomy: continence and margins Eur. Urol. 1995. Vol. 28, 2 P 202-208.

42. Brooks J.P., Albert P.S., Wilder R.B. et al. Long-term salvage radiotherapy outcome after radical prostatectomy and relapse predictors J. Urol. 2005. Vol. 174, 6. P. 2204-2208.

43. Byar D., Mostofi F.K. Carcinoma of the prostate: prognostic evaluation of certain pathologic features in 208 radical prostatectomies. Examined by stepsection technique Cancer. 1972. Vol. 30, 1. P. 5-30.

44. Campbell E.W. Total prostatectomy with preliminary ligation of the vascular pedicles J. Urol. 1959. Vol. 81, 3. P. 464-467.

45. Cangiano T.G., Litwin M.S., Naitoh J. et al. Intraoperative frozen section monitoring of nerve sparing radical retro pubic prostatectomy J. Urol. 1999. Vol. 162, 3. P. 655-658.

46. Carter H.B., Piantadosi S., Isaacs J.T. Clinical evidence for and implications of the multistep envelopment of prostate cancer//J. Urol. 1990.-Vol. 143, 4. P. 742-746.

47. Carter H.B., Sauvageot J., Walsh P.C. et al. Prospective evaluation of men with stage Tic adenocarcinoma of the prostate J. Urol. 1997. Vol. 157, 6. P. 2206-2209.

48. Carver B.S., Bianco F.J. Jr., Scardino P.T. et al. Long-term outcome following

49. Catalona WJ., Stain A.J. Staging errors in clinically localized prostate cancer J. Urol 1982. Vol. 127, 2. P. 452-456.

50. Catalona W.J., Stain A.J., Fair W.R. Grading errors in prostatic needles biopsies: relation to the accuracy of tumor grade in predicting pelvic lymph node metastasis J. Urol 1982. Vol. 127, 5. P. 919-922.

51. Catalona W.J., Bigg S.W. Nerve-sparing radical prostatectomy: evaluation of results after 250 patients J. Urol. 1990. Vol. 143, 3. P. 538-544.

52. Catalona W.J,, Partin A.W., Slawin K.M. A multicenter clinical trial evaluation of free PSA in differentiation of prostate cancer from benign disease J. Urol. 1997.- Vol. 157, 1, part 2. P. 111.

53. Catalona W.J., Carvaihal G.F., Marger D.E. et al. Potency, continence and complications rates in 1,870 consecutive radical retropubic prostatectomy J. Urol 1999. Vol 162, 2. P. 433-438.

54. Catalona W.J., Antenor J. A., Roehl K.A. Screening for prostate cancer in high risk populations J. Urol 2002. Vol 168, 5. P. 1980-1983.

55. Catalona WJ., Loeb S. The PSA era is not over for prostate cancer Eur. Urol 2005. Vol 48, 4. P. 541-545.

57. Chun J., Pmthi R.S. Is neoadjuvant honnonal tiierapy before radical prostatectomy indicated? Urol Int. 2004. Vol. 72, 4. P. 275-280.

58. Civantos F., Soloway M.S., Pinto J.E. Histopathological effects of androgen deprivation in prostatic cancer Semin. Urol. Oncol. 1996. Vol 14, 2, suppl2.-P.22-31.

59. Civantos F. Difficulties in inteipreting specimens after neoadjuvant hormonal therapy and radiation with illustration of neuroendocrine differentiation Mol. Urol. -2000. -Vol. 4, 3. P 117-121.

60. Coetzee L.J., Hars V., Paulson D.F. Postoperative prostate-specific antigen as a prognostic indicator in patients with margin-positive prostate cancer, undergoing adjuvant radiotherapy after radical prostatectomy Urology. 1996. Vol. 47, 2. P. 232-235.

61. Cohen MS., Triaca V., Silvemian ML. et al. Progression of laparoscopic radical prostatectomy: improved outcomes with the extraperitoneal approach and a running anastomosis J, Endourol. 2006. Vol. 20, 8ю P. 574-579.

62. Collete L., van Poppel H., Bolla M. et al. Patients at high risk of progression after radical prostatectomy: do they all benefit from immediate post-operative irradiation? pORTC trial 22911) Eur. J. Cancer. 2005. Vol. 41, 17. P. 2662-2672.

63. Colombel M., Xavier M., Florence M.L. et al. Long-term survavial after prostate ectomy Eur. Urol. 2006. Vol. 5, suppL 2. P. 127, abstract 419.

64. Connolly S.S., OToole G.C., OMalley K.J. et al. Positive apical surgical margins after radical retropubic prostatectomy, truth or artefact? Scand. J. Urol. Nephrol. 2004. Vol. 38, 1. P. 26-31.

65. Cookson M.S., Fair W.R. Neoadjuvant androgen deprivation therapy and radical prostatectomy for clinically localized prostate cancer AUA Update Series. 1997. Vol. 16, 2. P. 98-92.

66. Comud F., Belin X., Flam T. et al. Local staging of prostate cancer by endorectal MM using fast spin-echo sequences: prospective correlation with pathological findings after radical prostatectomy Br. J. Urol. 1996. Vol. 77, 6 P. 843-850.

67. Crawford E.D. Epidemiology of prostate cancer Eur. Urol. 2003, Vol. 62, №6A.-P.3-12.

68. Cupp M.R., Bostwick D,G., Myers R.P. et al. The volume of prostate cancer in the biopsy specimen cannot reliably predict the quantity of cancer in the radical

69. Diblasio C.J., Kattan M.W. Use of nomograms to predict the risk of disease recurrence after definitive local therapy for prostate cancer Urology. 2003. -Vol.62,№6A.-P.9-18.

70. Djuvan В., Moul J.W., Zlotta A. et al. PSA profession following radical prostatectomy and radiation therapy: new standarts in new millennium Eur. Urol. 2003.-Vol. 43,№ L P. 12-27.

71. Djuvan В., Rocco В., Raveiy V. et al. European study on radical prostatectomy (ESPRE) part I: surgicals and oncological results and changes 1993 2004 Eur. Urol. 2006. Vol. 5, suppl. 2. P. 129, abstract 426.

72. Dominique S., Ravery V. Preoperative imaging studies: is there any necessity? EAU Update Series. 2005. Vol. 3. P. 72-76. Sl.Dussinger A.M., Beck S.D., Cheng L. et al. Does wide primaiy perirectal dissection during radical retropubic prostatectomy alter pathologic and biochemical outcomes? Urology. 2005. Vol. 66, suppl. 5. P. 95-100.

73. Eastham J.A,, Kattan M.W., RiedelE. et al. Variations among individual

74. Egawa S., Ohori M., Iwamura M. et al. Efficacy and limitations of delayed/salvage radiation therapy after radical prostatectomy BJU Int. 1999. "Vol. 84, Ш 7. P 815-820.

75. Eggleston J.C, Walsh P.C. Radical prostatectomy with preservation of sexual fimction: pathological findings in the first 100 cases J. Urol. 1985. Vol. 134, 6 P 1146-1148.

76. Emerson R.E., Koch M.O., Jones T.D. et al. The influence of extent of surgical margin positivity on prostate specific antigen гесштепсе J. Clin. Pathol. 2005. Vol. 58, 10. P. 1028-1032.

77. Epstein J.L Eveluation of radical prostatectomy capsular margins of resection: the significance of margins designated as negative, closely approaching, and positive Am. J. Clin. Path. 1990. Vol. 14, 7. P. 626-632.

78. Epstein J.L, Carmichael Т., Partin A.W. et al. Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage В adenocarcinomas of the prostate with 5 years of follow-up J. Urol. 1993. Vol. 149, 6. P. 1478-1481.

79. Epstein J.L, Carmichael M.J., Pizov G. et al. Influence of capsular penetration on progression following radical prostatectomy: a study of 196 cases with longterm follow-up J. Urol 1993. Vol. 150, 1. P. 135-141.

80. Epstein J.L, Pizov G., Walsh, P.C. Correlation of pathologic fmdings with progression after radical retropubic prostatectomy Cancer. 1993. Vol. 71, Jfo 7 P 3582-3593.

82. Epstein J.L, Partin A.W., Sauvageot J. et al. Prediction of progression following radical prostatectomy. A multivariate analysis of 721 men with long-term follow-up Am. J. Surg. Path. 1996. Vol. 20, 3. P. 286-292.

83. Epstein J.L, Sauvageot J. Do close but negative margins in radical prostatectomy specimens increase the risk of postoperative progression? J. Urol. 1997. Vol. 157, 1. P. 241-243.

85. Epstein J.L, Pound C.R., Partin A.W. et al. Disease progression following radical prostatectomy in men with Gleason score 7 tumor J. Urol. 1998. VoL 1 6 0 1 P 97-101.

86. Epstein J.L Patologic assessment of the surgical specimen Urol. Clin. North Am. 2001. Vol. 28, Jfs 3. P. 567-594.

87. Erdogra Т., Teber D., Frede T. et al. Comparison of transperitoneal and extraperitoneal laparoscopic radical prostatectomy using match-pair analysis Eur. Urol. 2004. Vol. 46, 3. P. 312-319.

88. Febbo P.G., Richie J.P., George D.J. et al. Neoadjuvant docetaxel before radical prostatectomy in patients with high-risk localized prostate cancer Clin. Cancer Res. 2005. Vol. 11, 14. P. 5233-5240.

89. Fendler J.P., Perrin P. Positive margins and residual disease following radical prostatectomy: prediction and therapy Cur. Opin. Urol. 1994. Vol. 4, 1.

90. Fessena Т., Sakr W., Grignon D. et al. Prognostic implications of a positive apical margin in radical prostatectomy specimens J. Urol. 1997. Vol. 158, Jfs 6.™ P. 2176-2179. lOl.Frazier H.A., Robertson J.E., Paulson D.F. Radical prostatectomy: the pros and cons of the perineal versus retropubic approach J. Urol. 1992. Vol. 147, Х й З P 888-890.

91. Freedland S.J., Aronson W.J., Presti J.C. et al. Should a positive surgical margin following radical prostatectomy be pathological stage T2 or T3? Results from the search database J. Urol. 2003. Vol. 169, 6. P. 2142-2146.

92. Ghavamian R., Knoll A,, Boczko J. et al. Comparison of operative and functional outcomes of laparoscopic radical prostatectomy and radical retropubic prostatectomy: single surgeon experience Urology. 2006. Vol. 67, 6 P 1241-1246.

93. Ghobrial LM,, Witzig Т.Е., Adjei A.A. Targeting apoptosis pathways in cancer therapy CA Cancer J. Clin. 2005. Vol. 55. P. 178-194.

94. Gibbons R.P., Cole B.S., Richardson R.G. et al. Adjuvant radiotherapy following radical prostatectomy: results and complications J. Urol. 1986. Vol. 135,№l.-P.65-68.

95. Gleave M.E., Goldenberg S.L., Chin J.I. et al. Randomized comparative study of 3 versus 8-month neoadjuvant hormonal therapy before radical prostatectomy: biochemical and pathological effects J. Urol. 2001. Vol. 166, 2 P 500-507.

96. Goetz T,, Neugart F., Groh R. et al. Radical peroneal prostatectomy a single institution study on prospectively controlled results in a consecutive serie of 1400 cases J. Urol 2006. Vol. 175, 4. P. 208, abstract 648.

97. Goldenberg S.L., Klotz L.H., Jewett M.A. et al. Randomized, prospective, controlled study comparing radical prostatectomy alone and neoadjuvant androgene withdrawal in the treatment of localized prostate cancer J. Urol. 1996. Vol. 156, 3. P. 873-877.

98. Gomella L.G., Zeltser L, Valicenti R. Use of neoadjuvant and adjuvant therapy to prevent or delay recurrence of prostate cancer in partients undergoing surgical treatment for prostate cancer Urology. 2003. Vol. 62, №6B.-P.46-54.

99. Gomez C.A., Soloway M.S., Civantos F. et al. Bladder neck preservation and its impact on positive surgical margins during radical prostatectomy Urolo. 1993. Vol. 42, 6. P. 689-693.

100. Greafen M., Uwe H.G., Heinzer H. Indication, technique and outcome of retropubic nerve-sparing radical prostatectomy EAU Update Series. 2005. Vol. 3 P 77-85.

101. Gripion D.J., Sakr W.A. Pathologic staging of prostate carcinoma. What are the issues Cancer. 1996. Vol. 78, 1. P. 337-340.

102. Grossfeld G.D., Chang J.J., Broering J.M. et al. Impact of positive surgical margins on prostate cancer recurrence and the use of secondary cancer treatment: data from the CaPSURE database J. Urol. 2000. Vol. 163, 4. P 1171-1177.

103. Grossfeld G.D., Tigrani V.S., Nudell D. et al. Managment of a positive surgical margin after radical prostatectomy: decision analysis J. Urol. 2000. V o l 164, 1 P 93-100.

104. Guillonneau В., El-Fettouch H., Cathelineau X. et al. Laparoscopic radical prostatectomy. Oncological evaluation after 1000 patients at Montsouris institute J. Urol. 2002. Vol. 169, 6. P. 1694-1696.

105. Gutierrez R. New concepts in the surgical treatment of prostatic carcinoma Arch. Cuba Cancerol. 1949. Vol. 8, 10. P. 340-372.

106. Harris R.D., Schned A.R., Heaney J.A. Staging of prostate cancer with endorectal MR imaging: lessons from a learning curve Radiographics. 1995.-Vol. 15, 4 P 813-829.

107. Harris M.J. Radical perineal prostatectomy: cost efficient, outcome effective, minimally invasive prostate cancer management Eur. Urol. 2003 Vol. 44, 3. P. 303-308.

108. Hegarty N.J., Kaouk J.H. Radical prostatectomy: a comparison of open, laparoscopic and robot-assisted laparoscopic techniques Can. J. Urol. 2006. V o l 13, suppl. 1. P 56-61.

109. Hernandez D.J., Epstein J.L, Trock B.J. et a l Radical retropubic prostatectomy. How often do experienced surgeons have positive surgical margins when there is extraprostatic extension in the region of the neurovascular bundle? J. Urol. 2005. Vol. 173, 2. P. 446-449.

110. Hocht S., Wiegel Т., Schostak M. et al. Adjuvant and salvage radiotherapy after radical prostatectomy Onkologie. 2002. Vol. 25, Ш 3. P. 201-206.

111. Hodge K.K., McNeal J.E., Terris M.K. et al. Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate J. Urol. 1989. V o l 142, 1. P 68-91.

112. Holund B. Latent prostatic cancer in a consecutive autopsy series Scand. J. Urol. Nephrol. 1980. Vol. 14, Xs 1. P. 29-35.

113. Horsch R., Jung H., Gotz T. et al. Radical perineal prostatectomy a single institution study on prospectively controlled results in a consecutive series of 1220 cases Eur. Urol. 2005. Vol. 4, N 3. P. 102, abstract 393.

114. Huland H., Hammerer P., Henke R. et al. Preoperative prediction of tumor heterogeneity and recurrence after radical prostatectomy for localid prostatic carcinoma with digital rectal examination, prostate specific antigen and the results of 6 systematic biopsies J. Urol. 1996. Vol. 155, Ш 4. P. 13441347.

115. Hull G. W., Rabbani F., Abbas F. et al. Cancer control with radical

116. Ickowski K.A,, Casella G., Seppala R.J. et al. Needle core length in sextant biopsy influences prostate cancer detection rate Urology. 2002. Vol. 59, K« 5. P. 698-703.

117. Isoma M.S., Lopez-Tomasety B.J., Dominguez R. et al. Radical prostatectomy as monotherapy for locally advanced prostate cancer (T3a): 12 years follow-up Arch. Esp. Urol 2004. Vol. 57, Ш 7. P. 679-692.

118. Jemal A., Siegel R., Ward E. et al. Cancer Statistics, 2006 CA Cancer J. Clin. 2006. Vol. 56, 1. P .106-130.

119. Jones E.C. Resection margin status in radical retropubic prostatectomy specimens: relationship to type of operation, tumor size, tumor grade and local tumor extension J. Urol. 1990. Vol. 144, Jfe 1. P. 89-93.

120. Kamat A.M., Jacobson K.M., Trancoso P, et al. Validation of criteria used to predict exfraprostatic cancer extension: a tool for use in selecting patients for nerve sparing radical prostatectomy J. Urol. 2005. Vol. 174, 4. P. 1262- 1265.

121. Kattan M.W., Wheeler T.M., Scardino P.T. Postoperative nomogram for disease recurrence after radical prostatectomy for prostate cancer J. Clin. Oncol. 1999. -Vol. 17, 5. P 1499-1507.

122. Klein E.A., Kupelian P.A., Tuason L. et al. Initial dissection of the lateral fascia reduces the positive margin rate in radical prostatectomy Urology. 1998. Vol. 51, 5. P. 766-773.

123. Klotz L.H., Goldenberg S.L., Jewett A.S. et al. Long-term follow-up of a randomized trial of 0 versus 3 months of neoadjuvant androgen ablation before radical prostatectomy J. Urol. 2003. Vol. 170, Ш 3. P. 791-794.

124. Lacquaniti S., De Giuli P., Fasolo P. et al. Intra-operative pathological staging of prostate cancer during radical retropubic prostatectomy Eur. Urol. 2006. Vol 5, suppl. 2. P. 100, abstract 310.

125. Lange P.H., ReddyP.K., MediniP. et al. Radiation therapy as adjuvant

126. Laven B.A., Alsikafi N.F., Yang J.X. et al. Minor modifications in apical dissection of radical retropubic prostatectomy in patients with clinical stage T2 prostate cancer reduce positive surgical margins incidence Urology. 2004. Vol.63,№l.-P.95-98.

127. Leibovich B.C., Engen D.E., Patterson D.E. et al. Benefit of adjuvant radiation therapy for Localized cancer with a positive surgical margin J. Urol. 2000. Vol. 163, 4. P. 1178-1182.

128. Lepor H., Kaci L. Role of intraoperative biopsies during radical retropubic prostatectomy Urology. 2004. Vol. 63, 3. P. 499-502.

129. Lemer S.E., Blute M.L., Zincke H. Extended experience with radical prostatectomy for clinical stage T3 prostate cancer: outcome and contemporary morbidity//J. Urol.-1995.-Vol. 154,№4.P. 1447-1452.

130. Licht M.R., Klein E.A., Tuason L. et al. Impact of bladder neck preservation during radical prostatectomy on continence and cancer control Urology. 1994. Vol. 44, Ш 6. P. 883-887.

131. Link P., Freiha F.S., Stamey T.A. Adjuvant radiation therapy in patients with detectable prostate specific antigen following radical prostatectomy J. Urol. 1991. Vol. 145, m 3. P. 532-534.

132. Llorente C De La Morena J., Martin D. et al. Influence of the extent of positive surgical margins on biochemical recurrence after radical retropubic prostatectomy Eur. Urol 2006. Vol. 5, suppl. 2. P 128, abstract 421.

133. Loch Т., McNeal J.E., Stamey T.A. Interpretation of bilateral positive biopsies in prostate cancer J. Urol. 1995. Vol. 154, 3. P. 1078-1083.

134. Lotan Y., Shariat S.F., Khoddami S.M. et al. The percent of biopsy cores positive for cancer is a predictor of advanced pathological stage and poor clinical outcomes in patients treated with radical prostatectomy// J. Urol. 2004. Vol. 171, 6. P. 2209-2214.

135. LoweB.A., Lieberman S.F. Disease recurrence and progression in untreated

136. Marcovich R., Wojno K.J., Wei J.T. et al. Bladder neck-sparing modification of radical prostatectomy adveiely affecte surgical margins in pathologic T3a prostate cancer Urology. 2000. Vol. 55, 6. P. 904-908.

137. Masieri L., Semi S., Lapini A. et aL Anterograde radical retropubic prostatectomy for cure clinically localized prostate cancer: oncological outcome in a 17-year series Eur. Urol. 2006. Vol. 5, suppl. 2. P. 129, abstract 428.

138. Miller G.J. Pathologic aspects of prostate cancer: prediction of malignant potential Urology. 1989. Vol. 34, Suppl. 14. P. 5-9.

139. Millin T. Retropubic prostatectomy: new extravesical technique. Report on 20 cases Lancet. 1947. Vol 2, 6379. P. 693-696.

140. Miyata Y., Kanda S., Sakai H. Relationship between changes in prostate cancer cell proliferation, apoptotic index, and expression of apoptosis-related pro-teins by neoadjuvant hormonal therapy and duration of such treatment Urology. 2005. Vol. 65, 6. P. 1248-1243.

141. Montironi R., van der Kwast Т., Boccon-Gibod L. et al. Handling and pathology reporting of radical prostatectomy specimens Eur. Urol 2003. Vol. 44, 6. P. 626-636.

142. Montironi R., Vela-Navarrete R., Lopez-Beltrane A. e t a l 2005 Update on

143. Moul J.W. Prostate specific antigen only progression of prostate cancer J. Urol. 2000. Vol. 163, Ш 6. P. 1632-1642.

144. Moul J., Wu H., Sun L. et al. Epidemiology of radical prostatectomy for localized prostate cancer in the era of prostate-specific antigen: an overview of the Department of Defense Center for Prostate Disee Research national database Surgery. 2002. Vol. 132, 2. P. 213-219.

145. Myers R.P. Improving the exposure of the prostate in radical retropubic prostatectomy: Longitudinal bunching of the deep venous plexus J. Urol. 1989. Vol. 129, 5. P. 1007-1008.

146. Myers R.P. Male urethral sphincter anatomy and radical prostatectomy Urol. Clin. North Am. 1991. Vol. 18, 2. P. 211-227.

147. Nasseri K.K., Austenfeld M.S. PSA recurrence after definitive treatment of clinically localized prostate cancer AUA Update Series. 1997. Vol. 16, 1.-P. 82-89.

148. Naya Y., Slaton J.W., Troncoso P. et al. Tumor length and location of cancer on biopsy predict for side specific extraprostatic cancer extension J. Urol. 2004.Vol. 1 7 1 3 P 1093-1097. 167. Ng J.C, Koch M.O., Daggy J.K. et al. Perineural invasion in radical prostatectomy specimens: lack of prognostic significance J. Urol. 2004. Vol. 172, 6. P.2249-2251.

150. Noldus J., Palisaar J., Huland H. et al. Treatment of prostate cancer the clinical use of radical prostatectomy Eur. Urol. 2003. Vol. 1, l P 150.

151. Ochiai A., Troncoso P., Chen ME. et al. The relationship between tumor

152. Oesterling J.E., Suman V.J., Zincke H. et al. PSA-detected (clinical stage Tic or BO) prostate cancer. Pathologically significant tumors Urol. Clin. North Am. 1993. Vol. 20, 4. P. 687-693. 172. Oh W.K. Neoadjuvant and adjuvant systemic therapy in high-risk localized prostate cancer ASCO. 2

153. Educational Book. 40 Annual Meeting, New Orleans. P. 243-247.

154. Ohori M., Wheeler T.M., Kattan M.W. et al. Prognostic significance of positive surgical margins in radical prostatectomy specimens J. Urol. 1995. V o l 154, 6 P 1818-1824.

155. Ohori M., Kattan M.W., Koh H. et al. Predicting the presence and side of extracapsular extension: a nomogram for staging prostate cancer J. Urol. 2004.-Vol. 171, 5 P 1844-1849.

156. Ojea C.A., Gonzalez P.A., Dominguez F.F. Prognostic implications of positive margins in radical prostatectomy specimens Actas. Urol. Esp. 2005. Vol. 29, 7. P. 641-647.

157. Ozkan F. Correlation of perineural invasion on radical retropubic specimens with other pathologic prognostic factoid ands PSA failure Eur. urol. 2001. V o l 40, 2 P 308-312.

158. Partin A.W., Borland R.N., Epstein J.L et al. Influence of wide excision of the neurovascular bundle(s) on prognosis in men with climcally localized prostate cancer with established capsular penetration J. Urol. 1993. Vol. 1 5 0 1 P 142-148.

159. Partin A.W., Mangold L.A., Lamm D.M. et al. Contemporary update of prostate cancer staging nomograms (Partin tables) for the new millennium Urology. 2001. Vol. 58, 6. P. 843-848.

160. Paulson D.F., Stone A.R., Walther P.J. et al. Radical prostatectomy: anatomical predictors of success or failure J. Urol. 1986. Vol. 136, 5.

161. Paulson D.F., Moul J.W., Walther P.J. Radical prostatectomy for clinical stage T1-2N0M0 prostatic adenocarcinoma: long-term results J. Uroi. 1990. -Vol. 1 4 4 4 P 1180-1183.

162. Paulson D.F. Perineal prostatectomy In: Campbells Urology (6th edition)/ Ed. by P.C. Walsh, A.B. Retik, T.A. Stamey, E.D. Vaughan. Philadelphia; W. B. Saunders Company. 1992.- chapt. 79. P. 2887-2899.

163. Paulson D.F. Impact of radical prostatectomy in the management of clinically localized disease J. Urol. 1994. Vol. 152, 5 part 2. P. 18261830.

164. Paulson D.F. Radical perineal prostatectomy: a 20 year experience J. Urol. 1997. Vol. 157, part 2. P. 92, abstract 358.

165. Pazona J.F., Han M., Hawkins S.A. et al. Salvage radiation therapy for prostate specific antigen progression following radical prostatectomy: 10-year outcome estimates J. Urol. 2004. Vol. 174, 4. P. 1282-1286.

166. Perrotti M., Kaufinan R.P., Jennings T.A. et al. Endorectal coil magnetic resonance imaging in clinically localized prostate cancer: is it accurate? J. Urol 1996. Vol. 166, Jfo 1. P. 106-109.

167. Petrovich Z., Lieskovsky G., Langholz B. et al. Radical prostatectomy and post-operative irradiation in patients with pathological stage С (T3) carcinoma of the prostate Int. J. Radiat. Oncol. Biol. Phys. 1998. Vol.40, 1. p. 139-147.

168. Pettus J.A., Weight C.J., Thompson C.J. et al. Biochemical failure in men following radical retro pubic prostatectomy: impact of surgical margin status and location J. Urol. 2004. Vol. 172, 5. P. 791-794.

169. Pisansky T.M., Kozelsky T.F., Myei R.P. et al. Radiotherapy for isolated serum prostate specific antigen evaluation after prostatectomy for prostate cancer J. Urol. 2000. Vol. 163, 3. P. 845-850.

170. Polito M., Muzzonigro G., Minardi D. et al. Eifects of neoadjuvant androgen deprivation therapy on prostatic cancer//Eur. Urol. 1996. -Vol. 30, suppL

171. Ponthieu A., DelgrandeJ., Granger F. et al. Extemporaneous histological control of margins in prostatectomy for cancer J. Urol. (Paris) 1993. Vol. 99, 2 P 67-72.

172. Poon M., Bamshad R., Tsai C. et al. Urinary complications following radical retropubic prostatectomy: bladder neck preservation versus two different methods of bladder neck preservation J. Urol. 1997. Vol. 157, part 2. P. 390, abstract 1528.

173. Poon M., Ruckle H., Bamshad R. et al. Radical retropubic prostatectomy: bladder neck preservation versus reconstruction J. Urol. 2000. Vol. 163, 1 P. 194-198.

174. Porpigiia F., Terrone C.,Tarabuzzi R. et al. Transperitoneal versus extraperitoneal laparoscopic radical prostatectomy: experience of a single center Urology. 2006. Vol. 68, 2. P.376-380.

175. Pound C.R., Partin A.W., Eisenberger M.A. Natural history of progression after PSA elevation following radical prostatectomy JAMA. 1999, Vol. 281, 1 7 P 1591-1597.

176. Powell I.J., Tangen СМ., Miller G.J. et al. Neoadjuvant therapy before radical prostatectomy for clinical T3/T4 carcinoma of the prostate: 5-year foUowup, phase II southwest oncology group study 9109 J. Urol. 2002. Vol. 168, 5 P 2016-2019.

177. Prezioso D., Galasso R., Di Martino M. et al. Role of surgery in treatment of locally advanced prostate cancer Anticancer Res. 2006. Vol. 26, 4B. P. 3151-3158.

178. Quinn M., Babb P. Patterns and trends in prostate cancer incidence, survival, prevalence, and mortality B.J.U. Int. 2002. Vol. 90, Ife 1. P. 162-173.

179. Quinlan D., Epstain J., Carter B. Sexual fimction following radical prostatectomy: influence of preservation of neurovascular bundle J. Urol. 1991.-Vol. 145, 5 P 998-1002.

180. Rabbani P., Bastar A., Fair W.R. Site specific predictors of positive margins

181. Rabbani F., Goldenberg S.L., Klotz L.H. et al. Predictors of pathological stage befor neoadjuvant androgen withdrawl therapy and radical prostatectomy 1 Urol. 1998. Vol. 159, 3. P. 925-928.

182. Raboy A., Ferzli G., Albert P. Initial exerience with extraperitoneal endoscopic radical retropubic prostatectomy Urology. 1997. Vol. 50, Ш 6 P 849-853.

183. Ravery V., Schmid H.P., Toublanc M. et al. Is the percentage of cancer in biopsy cores predictive of extracapsular disease in T1-T2 prostate carcinoma? Cancer. 1996. Vol.78, 5. P. 1079-1084.

184. Richie J.P. Management of patients with positive surgical margins following radical prostatectomy Urol. Clin. North Am. 1994. Vol. 21, Кэ 4. P. 717-723.

185. Rifkin M.D., Zerhouni E.A., Gatsonis C.A. et al. Comparison of magnetic resonance imaging and ultrasonography in staging early prostate cancer: results of a multi-institutional cooperative trial New Engl. J. Med. 1990. Vol. 323, 4 P 621-626.

186. Rogers R., Roach M., Presti J. et al. Radiation therapy for the management of biopsy proven, local recurrence following radical prostatectomy J. Urol. 1997. V o l 157, part2. P 291, abstract 1131.

187. Rosen M.A., Goldstone L., Lapin S. et al. Frequency and location extracapsular extension and positive surgical margins in radical prostatectomy specimens J. Urol. 1992. Vol. 148, Xs 2 part 1. P. 331-337.

188. Sakr W.A., Grignon D.J., Visscher D.W. et al. Eveluating the radical prostatectomy specimen: a protocol for establishing prognostic parameters and harvesting fresh tissue samples J. Urol. Path. 1995. Vol. 3, Ш 2. P. 355364.

189. Salo J.O., Kivisaari L., Rannikko S. et al. Computerized tomography and transrectal ultrasound in the assessment of local extension of prostatic cancer

190. Salomon L., Anastasiadis A.G., Levrel O. et al. Location of positive surgical margins after retropubic, perineal, and laparoscopic radical prostatectomy for organ-confined prostate cancer Urology. 2003. Vol. 61, 2. P. 386390.

191. Scaletscky R., Kock M.O., Eckstein C.W. et al. Tumor volume and stage in carcinoma of the prostate detected by elevations in prostate specific antigen J. Urol.-1994.-Vol. 152, l P 129-131.

192. Schellhammer P.F. Radical prostatectomy: patterns of local failure and survival in 67 patients Urology. 1988. Vol. 31, 3. P. 191-197.

193. Schild S.E., Buskirk S.J., Wong W.W. et al. The use of radiotherapy for patients with isolated elevation of serum prostate specific antigen following radical prostatectomy J. Urol. 1996. Vol. 156, 5. P. 1725-1729.

194. Schroder F.H. Hormonal treatment of prostate cancer In: Campbells Urology (8th edition)/ Ed. by P.C. Walsh, A.B. Retik, E.D. Vaughan. Philadelphia; W. B. Saunders Company. -2

196. Schuessler W.W., Schulman P.O., Dayman R.V. et al. Laparoscopic radical prostatectomy: Initial short-term experience Urology. 1997. Vol. 50, 6. P 854-857.

197. Scolieri M.J., Altman A., Resnick M.L Neoadjuvant hormonal ablative therapy before radical prostatectomy: a review. Is it indicated? J. Urol. -2000. V o l 164, 5. P 1465-1472.

198. Selli C Montironi R., Bono A. et al. Effects of complete androgen blockade for 12 and 24 weeks on the pathological stage and resection margin status of prostate cancer J. Clin. Pathol 2002. Vol 55, 7. P. 508-513.

199. Semi S., Masieri L., Lapini A. et al. A low incidence of positive surgical margins in prostate cancer at high risk of extracapsular extension after a modified anterograde radical prostatectomy B.J.U. Int. 2004. Vol. 93, 3 P 279-283.

200. Semi S., Masieri L., Minervini A. et a l Cancer progression after anterograde radical prostatectomy for pathologic Gleason score 8 to 10 and influence of concomitant variables Urology. 2006. Vol. 67, 2. P. 373-378.

201. Shah O., Melamed J., Lepor H. Analysis of apical soft tissue margins during radical retropubic prostatectomy J. Urol. 2001. Vol. 165, 6. P. 19431949.

202. Shelfo S.W., Obek C Soloway M.S. Update on bladder neck preservation during radical retropubic prostatectomy: impact on pathologic outcome, anastomotic strictures and continence Urology. 1998. Vol. 51, №1. P. 73-78.

203. Shuford M.D., Cookson M.S., Chang S.S. et al. Adverse prognostic significance of capsular incision with radical retropubic prostatectomy J. Urol.-2004.-Vol. 1 7 2 1 P 119-123.

204. Simon M.A., Kim S., Soloway M.S. Prostate specific antigen recurrence rates are low after radical retropubic prostatectomy J. Urol. 2006. Vol. 175,№L-P.140-144.

205. Smith D.M., Murphy W.M. Histologic changes in prostatic carcinomas treated with leuprolide (lutenizing hormone-releasing hormone effect): distignitionfi-ompoor tumor differentiatiwi Cancer. 1994. Vol. 73, 5. P. 1472-1477.

206. Smith R.C, Partin A.W., Epstein J.L et al. Extended follow-up of the influence of wide excision of tiie neurovascular bundle(s) on prognosis in men with clinically localized prostate cancer and extensive capsular perforation J. Urol. 1996. Vol. 156, 2. P. 454-457.

207. Smith C.V., Bauer J.J., Connelly R.R. et al. Prostate cancer in men age 50 years or younger: a review of the Departnent of Defense Center for Prostate Disease Research multicenter prostate cancer database J. Urol. 2000. Vol. 164, 6 P 1964-1967.

208. Smith R.A., Cokkinides V,, Eyre H.J. American Cancer Society Guidelines for the Early Detection of Cancer, 2006 CA Cancer J. Clin. 2006. Vol. 56,

209. Sofer M., Hamilton-Nelson K.L., Cavintos F. et al. Positive surgical margins after radical retropubic prostatectomy: the influence of site and number on progression J. Urol. 2002. Vol. 467, 6. P. 2453-2456.

210. Soloway M.S., Sharifi R., Wajsman Z. et al. Randomized prospective study comparing radical prostatectomy alone versus radical prostatectomy preceded by androgene blockade in clinical stage B2 (T2bNxM0) prostate cancer: the Lupron Depot Neoadjuvant Prostate Cancer Study Group J. Urol. 1995. Vol. 154, 2 P 424-428.

211. Soloway M.S., Pareek K., Sharifi R. et al. Neoadjuvant androgen ablaticm before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results J. Urol.-2002.-Vol. 167,№ l P 112-116.

212. Soulie M., Seguin P., Benoit J. et al. Impact of a modified apical dissection during radical retropubic prostatectomy on the occurrence of positive surgical margins: a comparative study in 212 patients Urolo. 2001. Vol. 58, 2 P 217-221.

213. Stamey T.A., McNeal J.E., Freiha F.S. et al, Moiphometric and clinical studies on 68 consecutive radical prostatectomies J. Urol. 1

215. Stamey T.A., Villere A,A., McNeal J.E. et al. Positive surgical margins at radical prostatectomy: impotence of the apical dissection J. Urol. 1990. Vol. 1 4 3 3 P 1166-1173.

216. Stamey T.A., McNeal J.E. Adenocarcinoma of the prostate In: Campbells Urology (6th edition, Vol. 2)/ Ed. by P.C. Walsh, A.B. Retik, T.A. Stamey, E. D., Vaughan. Philadelphia; W. B. Saunders Company. 1992. 1159 p.

217. Stamey T.A. Techniques for avoiding positive surgical margins during radical prostatectomy A t Urol. Clin. North Am. 1994. Vol. 2, 2. P. 37-51.

218. Stephenson R.A., Middleton R,G., Abbott T,M. Wide excision (nonnerve sparing) radical retropubic prostatectomy using an initial perirectal dissection

219. Stephenson A.J., Shariat S.F., Zelefsky M.J. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy JAMA. 2004. Vol. 291,№ 1 1 P 1325-1332.

220. Stolzenburg J.U., Rabenalt R., Do M. et al. Endoscopic extraperitoneal radical retropubic prostatectomy (EERPE) ontological and functional results after 700 procedures//J. Urol.-2005.-Vol. 1 7 4 6 P 1271-1275.

221. Stovsky M.D., Resnick M.I. The diagnosis, prevention, and treatment of margin positive disease after radical prostatectomy for adenocarcinoma of the prostate AUA Update Series. 1997. Vol. 16, 1. P. 58-63.

222. Sullivan J.J., Hartwig C.H. The use of estrogen therapy preliminary to radical perineal prostatoseminal vesiculectomy in carcinGiwa of the prostate J. Urol. 1953. Vol. 70, 3. P. 499-502.

223. Swindle P., Eastham J.A., Ohori M. et al. Do margins matter? The prognostic significance of positive surgical margins in radical prostatectomy speoimens J. Urol. 2005. Vol. 174, 3. P. 903-907.

224. Syndikus L, Pickles Т., Kostashuk E. et al. Postoperative radiotherapy for stage pT3 carcinoma of the prostate: improved local control J. Urol. 1996. Vol. 155, 6 P 1983-1986.

225. Takayama Т.К., Lange P.H. Radiation therapy for local recurrence of prostate cancer after radical prostatectomy Urol. Clin. North Am. 1994. Vol. 21, 4 P 687-700.

226. Taneja S.S., Penson D.F., Epelbaum A. et al. Does site-specific labeling of sexant biopsy cores predict the site of extracapsular extension-in radical prostatectomy surgical specimen J. Urol. 1999. Vol. 162, 4. P. 13521358.

227. Taylor N., Kelly J.F., Kuban D.A. Adjuvant and salvage radiotiierapy after radical prostatectomy for prostate cancer Int. J. Radiat. Qncol. Biol. Phys. 2003. Vol. 56, 3. P. 755-763.

228. Thickman D., Speers W.C, Philpott P.J.etal. Effect of the number of core

229. Trae L.D, Surgical pathology examination of the prostate gland. Practice Survey by American Society of Clinical Pathologists Am. J. Clin. Path. 1994. Vol. 102, 5. P. 572-579.

230. Valicenti R.K., Gomella L.G., Perez C.A. Radiation tfierapy after radical prostatectomy: a review of the issues and options Semin. Radiat. (Mcol. 2003. Vol. 13, 2. P. 130-140.

231. Vallancien G., Cathelineau X., Baumert H. et al. Complications of transperitoneal laparoscopic surgeiy in urology: review of 1311 procedures at single center J. Urol 2002. Vol. 168, 1. P. 23-26.

232. Vesalainen S., Ыи)опеп P., Talja M. et al. Histological grade, perineural infiltration, tumor-infiltrating lymphocytes and apoptosis as determinants of long-term prognosis in prostatic adenocarcinoma Eur. J. Cancer. 1994: Vol. 30A,№ 1 2 P 1797-1803. 253. .Vicini F.A., Ziaja E.L., Kestin L.L. et al. Treatment outcome with adjuvant and salvage irradiation after radical prostatectomy for prostate cancer Urology.-1999. Vol. 54,№ l P 111-117.

233. Villers A., McNeal J.E., Redwine E. et al. The role of perineural space invasion in the local spread of prostatic carcinoma J. Urol. 1989. Vol. 142, 3 P 742-768.

234. Villers A., Stamey T.A., Yemoto С et al. Modified extrafascial radical

235. Voges G.E., McNeal J.E., Redwine J.A. et al. Morpological analysis of surgical margins with positive findings in prostatectomy for adenocarcinoma of the prostate Cancer. 1992. Vol. 69, 2. P. 520-526.

236. Walsh P.C., Donker P.J. Impotance following radical prostatectomy: insightinto etiology and prevention J. Urol. 1982. Vol. 128, Ш 2. P. 492-497.

237. Walsh P.C., Lepor H., Eggelston J.C Radical prostatectomy with preservation of sexual flmction: anatomical and pathological considirations Prostate. 1983. Ms 4, K« 5. P. 473-485.

238. Wang X., Brannigan R.E., Rademaker A.W. et al. One core positive prostate biopsy is a poor predictor of cancer .volume in the radical prostatectomy specimen//J. Urol.-1997.-Vol. 1 5 8 4 P 1431-1435.

239. Ward J.F., Zincke H., Bergstralh J. et al. The impact Qf surgical approach (nrve bundle preservation versus wide local excision) on surgical margins and biochemical recurrence following radical prostatectomy J. Urol. 2004. Vol. 172, 4. P 1328-1332.

240. Ward J.F., Slezak J.M., Blute M.L. et al. Radical prostatectomy for clinically advanced (cT3) prostate cancer since the advent of prostate-specific antigen testing: 15-year outcome B.J.U. Int. 2005. -Vol. 95, 6. P. 751-756.

241. Watson R.B., Civantos F., Soloway M.S. Positive surgical margins with radical prostatectomy: detailed pathological analysis and prognosis Urolo. 1996. Vol. 48, 1. P. 80-90.

242. Weldon V.E., Tavel F.R., Neuwirth H. et al. Patterns of positive specimen margins and detectable prostate specific antigen after radical perineal prostatectomy//J. Urol.- 1995.-Vol. 1 5 3 4 P 1561-1565.

243. Wieder J.A., Soloway M.S. Incidence, etiology, location, prevention and treatment of positive surgical margin after radical prostatectomy J. Urol. 1998.-Vol. 160,№ L-P.299-315.

244. Wiegel Т., Bressel M., Arps H. Radiotherapy of local recurence following

245. Wirth M., Froehner M. A review of studies of hormonal adjuvant therapy in prostate cancer Eur. Urol. 1999. Vol. 36, suppl. 2. P. 14-19.

246. Witjes W.P., Schulman C.C., Debrayne F.M. Preliminary results of a prospectire randomized study comparing radical prostatectomy versus radical prostatectomy associated with neoadjuvant hormonal combination therapy in T2-3 NO MO prostatic carcinoma Urology. 1997. Vol. 49, ЗА, suppl. 1. P 65-69.

247. Wood D.P., Peretsman S.J., Seay T.M, lacidence of benign and malignant. prostate tissue in biopsies of the bladder neck after a radical prostatectomy J. Urol. 1995." Vol. 154, 4. P. 1443-1446. 269. Wu J.J., King S.C., Montana G.S. et al. The efficacy of postprostatectomy radiotherapy in patients with an isolated elevation-of serum prostate-specific antigen Int. J. Radiat. Oncol. Biol. Phys. 1995. Vol. 32, 2. P. 317-

248. Young H.H. The cure of cancer of the prostate by radical perineal prostatectomy (prostate-seminal vesiculectomy): history, literature and statistics of Youngs operation J. Urol. --1945. Vol. 53, 1. P. 188-256. 271. Yu H., Diamandis E.P., Wong P. et al. Detection of prostate cancer relapse with prostate specific antigen monitoring at levels of 0.001 to 0,1 mg/1 J. Urol. 1997. -Vol. 157,Ш 3. P 913-918.

249. Zeitman A.L., Shipley W.U., Willett C.G. Residual disease after radical surgery or radiation therapy fwr prostate cancer: clinical significance and therapeutic implications Cancer. 1993. Vol. 71, suppl. 3. P. 959-969.