Prostatectomia Radical

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  • Perineal mapping biopsies may allow more accurate detection of unifocal or predominately unifocal cancers and allow focal therapy to be performed with precision. Neoadjuvant radiation (single dose) – will it reduce local recurrence Postoperative BCR – definition, timing of radiotherapy The detection of pros ca is increasing Many cancers detected today are indolent Radical therapy is very effective, but morbidity is too high for threat posed by indolent ca WW is appropriate for many ca but now well accepted More accurate staging (bx, MRI) can better characterize ca for risk-stratefied therapy Better technique can improve ca control and lower morbidity of RP and XRT Focal therapy may prove attractive for select focal cancers
  • Prostatectomia Radical

    1. 1. PROSTATECTOMIA RADICAL CARLOS EDUARDO CORRADI FONSECA CONGRESSO MINEIRO DE UROLOGIA TIRADENTES JULHO DE 2010
    2. 2. ESTIMATIVA INCA - 2010 <ul><li>489.720 casos novos de câncer </li></ul>INCIDÊNCIA POR NEOPLASIA pele 53.410 mama 49.240 estômago 13.820 pulmão 17.800 próstata 53.450
    3. 3. CÂNCER DA PRÓSTATA <ul><li>NEOPLASIA VISCERAL MAIS COMUM DO HOMEM </li></ul><ul><li>40% DOS TUMORES DO HOMEM ACIMA 50 ANOS </li></ul><ul><li>234.460 NOVOS CASOS/ANO USA </li></ul><ul><li>27.350 MORTES/ANO </li></ul><ul><li>53.450 NOVOS CASOS-2010 - BRASIL </li></ul><ul><li>MAIORIA ASSINTOMÁTICO </li></ul><ul><li>DIAGNÓSTICO PRECOCE: TOQUE E PSA </li></ul>
    4. 4. Prostatectomia Radical Planejamento <ul><li>Curar o câncer- evitar margens positivas </li></ul><ul><li>Continência </li></ul><ul><li>Preservar ou não os feixes vásculo-nervosos </li></ul>
    5. 7. Incisão
    6. 8. Incisão
    7. 11. Uretra
    8. 15. Preservação dos feixes vásculo-nervosos
    9. 19. Vesículas Seminais
    10. 27. Continência pós-operatória de PR (no pads) Patients remaining 647 43 14 5 0 96%
    11. 28. Recuperação da ereção após PR IIEF score >25 com ou sem medicação oral 647 183 44 16 0 Patients remaining 67%
    12. 29. <ul><li>OBRIGADO !!! </li></ul>

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