Background: Human placental allografts are widely used to promote wound healing. Placental (or amniotic membrane/umbilical cord) allografts are placed along the neurovascular bundles during radical prostatectomy to improve continence and erectile function recovery. It is unknown whether placental allografts impact biochemical recurrence (BCR). Methods: This was a single-surgeon retrospective study of 566 robotic radical prostatectomies performed from April 2015 to March 2021. The patients were divided into three groups: the negative control, Brand A, and Brand B. Brand A and Brand B were both cryopreserved amniotic membrane (CAM) allografts. A total of 324 cases were included for BCR Kaplan–Meier and risk-adjusted multivariate analyses (362 for continence analysis). In vitro analyses were performed to determine the effect of CAM allografts on prostate cancer (PCa) cell line growth. Results: For propensity score-matched analysis (adjusting for pre-operative PSA, tumor stage, Gleason Grade, and margin status), (1) the allograft groups did not show differences in time to BCR vs. the negative control group (p= 0.7), and (2) combined allograft treatment groups showed better continence recovery vs. the negative controls (p= 0.01). In vitro, placental allografts reduced PCa cell line growth in co-culture assays. Conclusions: cryopreserved AM allografts (combined or individual brands) did not show a significant effect on BCR but improved continence recovery for PCa patients.
背景：人胎盘同种异体移植物被广泛用于促进伤口愈合。在根治性前列腺切除术中，将胎盘（或羊膜/脐带）同种异体移植物沿神经血管束放置，以改善尿控功能和勃起功能恢复。目前尚不清楚胎盘同种异体移植物是否会影响生化复发（BCR）。方法：本研究为单外科医生回顾性研究，纳入了2015年4月至2021年3月期间进行的566例机器人辅助根治性前列腺切除术。患者被分为三组：阴性对照组、品牌A组和品牌B组。品牌A和品牌B均为冷冻保存的羊膜（CAM）同种异体移植物。共有324例纳入BCR的Kaplan-Meier分析和风险调整多变量分析（362例用于尿控功能分析）。同时进行了体外分析，以确定CAM同种异体移植物对前列腺癌细胞系生长的影响。结果：倾向评分匹配分析（调整术前PSA、肿瘤分期、格里森分级和切缘状态）显示：（1）与阴性对照组相比，同种异体移植物组在BCR时间上未显示出差异（p=0.7）；（2）与阴性对照组相比，联合同种异体移植物治疗组显示出更好的尿控功能恢复（p=0.01）。在体外共培养实验中，胎盘同种异体移植物减少了前列腺癌细胞系的生长。结论：冷冻保存的羊膜同种异体移植物（联合或单独品牌）对BCR未显示出显著影响，但改善了前列腺癌患者的尿控功能恢复。
Impact of Cryopreserved Placental Allografts on Biochemical Recurrence in Prostate Cancer
肿瘤(癌症)患者之家