ABSTRACT
OBJECTIVE: To investigate the learning curve of robotic-assisted laparoscopic radical prostatectomy (RALP) and analyze whether a surgeon's prior surgical experience has effects on the surgery. PATIENTS AND METHODS: From April 2012 to August 2015, 3 surgeons performed RALP on 355 consecutive patients with prostate cancer. Among these cases, 184 were by surgeon A with prior open experiences, 92 by surgeon B with both open and laparoscopic experiences, and 79 by surgeon C with laparoscopic experiences only. Perioperative, oncological, and functional outcomes were evaluated and compared between surgeons. Learning curve patterns were evaluated to determine the number of cases to reach plateau. RESULTS: Marked difference was observed in operative time among the 3 groups (all P <.05). Length of hospital stay was also statistically significant (all P <.001), except for that between Group B and Group C (P = .739). Continence at 1-year and 6-month postoperatively was better in Groups B and C compared with Group A (P <.001). Intraoperative blood loss, pathologic stage, positive surgical margin, biochemical recurrence-free rate, and other pathological findings showed no statistical significance between the groups. The number of cases required to reach plateau may vary for surgeons with different surgical experiences. CONCLUSION: Different early surgical background may affect the perioperative parameters of novice RALP surgeons. Previous laparoscopic experiences may provide additional advantage in learning curve parameters compared with surgeons with open experiences only. A better overall continence for laparoscopic surgeons requires further validation.
Subject(s)
Laparoscopy , Prostatectomy/methods , Robotic Surgical Procedures , Aged , Aged, 80 and over , China , Clinical Competence , Humans , Learning Curve , Male , Middle Aged , Retrospective Studies , Robotic Surgical Procedures/education , Seminal VesiclesABSTRACT
Hec1 (highly expressed in cancer) is a member of a conserved Ndc80 (nuclear division cycle 80) complex that regulates mitotic processes. Its overexpression is seen in various tumours and is associated with cancer progression. However, its expression pattern and role inhuman prostate cancer (PCa) still not clear. The aim of our study is to investigate the expression and functional role of Hec1 in human PCa. Hec1 expression was measured in 10 pairs of PCa cancerous and non-cancerous tissue samples by quantitative real-time (qRT)-PCR. The effects of Hec1 on PCa cells were studied by RNAi approach. Apoptosis and cell cycle were analysed by flow cytometry. Cells viability was evaluated using cell counting Kit-8. Cyclin B1-Cdc2 (cell division cycle 2) activity was measured by ELISA assay. Long non-coding (Lnc)RNAs regulated by Hec1 were gained from bioinformatics analysis. The role of LncRNA BX647187, regulated by Hec1, was finally characterized in PCa cells by siRNA. Our results showed that Hec1 mRNA and protein were significantly overexpressed in Human PCa tissues and several PCa cell lines. Silencing Hec1 markedly suppressed proliferation, promoted apoptosis and induced cell-cycle arrest in G2/M-phase in PCa cells. Through bioinformatics analysis and knockdown Hec1 in PCa cells, we found LncRNA BX647187 was positively regulated by Hec1. We further demonstrated that suppression of BX647187 in PCa cells significantly reduced cell proliferation and promoted apoptosis. Thus, we conclude that Hec1 is consistently overexpressed in human PCa and Hec1 is closely linked with human PCa progression through the meditator LncRNA BX647187. Our studies may contribute to understand the molecular mechanism of PCa pathogenesis and clinical therapy.
Subject(s)
Cell Proliferation/genetics , Nuclear Proteins/genetics , Prostatic Neoplasms/genetics , RNA, Long Noncoding/genetics , Apoptosis/genetics , Cell Line, Tumor , Cell Survival/genetics , Cytoskeletal Proteins , Gene Expression Regulation, Neoplastic , Gene Knockdown Techniques , Humans , Male , Nuclear Proteins/antagonists & inhibitors , Nuclear Proteins/biosynthesis , Prostatic Neoplasms/pathologyABSTRACT
OBJECTIVE: To assess the clinicopathological features and overall survival between two groups of Chinese patients older or younger than 70 years after retropubic radical prostatectomy. METHODS: From January 2001 to February 2010, 390 patients receive dretropubic radical prostatectomy. After excluding 89 patients with adjuvant or neoadjuvant hormonal therapy or radiotherapy, a total of 301 patients were included in this study. We arbitrarily divided these patients into younger age group (<70 years, 140 cases, 46.5%) and older age group (≥70 years, 161 cases, 53.5%). The differences in serum prostate specific antigen (PSA), Gleason score, clinical tumor stage, and biochemical-free survival were analyzed between the two groups. RESULTS: There were not significant differences between the two groups in high Gleason score rate and clinical tumor stage. However, older patients had significantly lower biochemical recurrence rate than those of younger patients, and had significantly higher PSA levels. Multivariate analysis showed that older age, PSA level and clinical tumor stage were significantly associated with biochemical recurrence free survival. CONCLUSION: In Chinese men, older age (≥70 years) is associated with better outcome. If the physical condition permits, older age alone should not exclude patients from radical prostatectomy.
