Evaluation of photodynamic diagnosis using 5-aminolevulinic acid during radical prostatectomy for the detection of positive surgical margins

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  • 根治的前立腺全摘除術の外科的切除断端における残存癌検出を目指した術中光力学診断の有用性の検討
  • コンジテキ ゼンリツセン ゼンテキジョジュツ ノ ゲカテキ セツジョダンタン ニ オケル ザンソンガン ケンシュツ オ メザシタ ジュッチュウ コウリョクガク シンダン ノ ユウヨウセイ ノ ケントウ

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Abstract

  Introduction：Positive surgical margins in prostate cancer are a significant risk factor for biochemical recurrence. We investigated the feasibility of intraoperative photodynamic diagnosis using 5-ALA in prostate cancer. <br>  Method：All patients were diagnosed with prostate cancer by biopsy. Radical prostatectomy was performed for those patients（18 cases of open surgery, 9 cases of laparoscopic surgery）. Three hours prior to observation, 1 g of 5-ALA dissolve in 50 ml of 5% glucose solution was given orally though a stomach tube. The laparoscope was positioned to observe in front of the margins. The harvested prostate was sectioned and examined by PDD. Red fluorescent-positive and -negative areas were biopsied and compared with the pathological results. <br>  Results：In all 27 cases, one patient had a red fluorescent-positive margin of the harvested prostate in the capsule and histologically comfirmed extraprostatic extension. In a section of the harvested prostate, the sensitivity and specificity were 53.9 and 89.3% respectively. <br>  Conclusion：Intraoperative photodynamic diagnosis indicates the possible feasibility for the detection of positive surgical margins in prostate cancer.

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