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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">agx</journal-id><journal-title-group><journal-title xml:lang="ru">Андрология и генитальная хирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Andrology and Genital Surgery</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2070-9781</issn><issn pub-type="epub">2412-8902</issn><publisher><publisher-name></publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17650/2070-9781-2022-23-2-34-46</article-id><article-id custom-type="elpub" pub-id-type="custom">agx-563</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНАЯ СТАТЬЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL REPORT</subject></subj-group></article-categories><title-group><article-title>Сравнительный анализ малоинвазивных методов  лечения локализованного рака предстательной железы</article-title><trans-title-group xml:lang="en"><trans-title>Comparative analysis of minimally invasive methods of treatment of localized prostate cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9056-9791</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чиненов</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chinenov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Денис Владимирович Чиненов</p><p>119435 Москва, ул. Большая Пироговская, 2, стр. 1</p></bio><bio xml:lang="en"><p>Denis Vladimirovich Chinenov</p><p>Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992</p></bio><email xlink:type="simple">chinenov_dv@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1121-9430</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шпоть</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shpot</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119435 Москва, ул. Большая Пироговская, 2, стр. 1</p></bio><bio xml:lang="en"><p>Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8425-9017</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чернов</surname><given-names>Я. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernov</surname><given-names>Ya. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119435 Москва, ул. Большая Пироговская, 2, стр. 1</p></bio><bio xml:lang="en"><p>Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1846-0270</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цуккиев</surname><given-names>З. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsukkiev</surname><given-names>Z. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119991 Москва, ул. Трубецкая, 8, стр. 2</p></bio><bio xml:lang="en"><p>Bld. 2, 8 Trubetskaya St., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6767-3224</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Вотяков</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Votyakov</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119435 Москва, ул. Большая Пироговская, 2, стр. 1</p></bio><bio xml:lang="en"><p>Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2489-606X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Курбанов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kurbanov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119991 Москва, ул. Трубецкая, 8, стр. 2</p></bio><bio xml:lang="en"><p>Bld. 2, 8 Trubetskaya St., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0548-190X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Исмаилов</surname><given-names>Х. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Ismailov</surname><given-names>H. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119991 Москва, ул. Трубецкая, 8, стр. 2</p></bio><bio xml:lang="en"><p>Bld. 2, 8 Trubetskaya St., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8099-3599</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лернер</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lerner</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119435 Москва, ул. Большая Пироговская, 2, стр. 1</p></bio><bio xml:lang="en"><p>Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7787-1240</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рапопорт</surname><given-names>Л. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Rapoport</surname><given-names>L. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119435 Москва, ул. Большая Пироговская, 2, стр. 1</p></bio><bio xml:lang="en"><p>Bld. 1, 2 Bolshaya Pirogovskaya St., Moscow 119992</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Клиника урологии им. Р.М. Фронштейна ФГАОУ ВО Первый Московский государственный медицинский университет  им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>R.M. Fronstein Urology Clinic, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>23</day><month>06</month><year>2022</year></pub-date><volume>23</volume><issue>2</issue><fpage>34</fpage><lpage>46</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Чиненов Д.В., Шпоть Е.В., Чернов Я.Н., Цуккиев З.К., Вотяков А.Ю., Курбанов А.А., Исмаилов Х.М., Лернер Ю.В., Рапопорт Л.М., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Чиненов Д.В., Шпоть Е.В., Чернов Я.Н., Цуккиев З.К., Вотяков А.Ю., Курбанов А.А., Исмаилов Х.М., Лернер Ю.В., Рапопорт Л.М.</copyright-holder><copyright-holder xml:lang="en">Chinenov D.V., Shpot E.V., Chernov Y.N., Tsukkiev Z.K., Votyakov A.Y., Kurbanov A.A., Ismailov H.M., Lerner Y.V., Rapoport L.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://agx.elpub.ru/jour/article/view/563">https://agx.elpub.ru/jour/article/view/563</self-uri><abstract><p>Цель исследования – изучение функциональных и онкологических результатов лечения локализованного рака предстательной железы (РПЖ) с помощью малоинвазивных методов.</p><sec><title>Материалы и методы</title><p>Материалы и методы. В нашем исследовании представлены 160 пациентов с локализованным РПЖ, которым было проведено лечение малоинвазивными методами: криобляция (n = 53), брахитерапия (n = 52), высокоинтенсивная фокусированная ультразвуковая (ВИФУ) терапия (n = 55). В качестве оценки онкологического результата использовали показатели общего простатического специфического антигена и результаты повторных трансректальных биопсий предстательной железы. Оценка функциональных показателей и качества жизни проводилась по результатам анкетирования c использованием опросников МИЭФ-5 (международный индекс эректильной функции), IPSS (International Prostate Symptom Score, международная шкала оценки симптомов при заболеваниях пред стательной железы), QoL (Quality of Life, опросник по качеству жизни), а также анализа показателя Qmax (максимальная скорость мочеиспускания).</p></sec><sec><title>Результаты</title><p>Результаты. Результаты онкологического контроля по данным положительных повторных биопсий были хуже у пациентов после криоабляции (7,54 %), лучшие онкологические результаты наблюдались у пациентов после брахитерапии. Показатель по шкале IPSS был статистически значимо хуже в группе брахитерапии по сравнению с другими группами в раннем послеоперационном периоде, однако данные различия не достигают уровня статистической значимости в позднем периоде у пациентов групп брахитерапии и криоабляции. Пациенты группы криоабляции продемонстрировали худшие показатели МИЭФ-5 в раннем послеоперационном периоде, в позднем периоде наблюдения показатели эректильной функции у пациентов группы криоабляции статистически значимо не отличались от таковых у пациентов после брахитерапии. Пациенты после ВИФУ-терапии показали меньше случаев эректильной дисфункции de novo за период наблюдения в 3 года, более высокие средние показатели МИЭФ-5, более низкие показатели баллов IPSS и лучшие результаты по опроснику QoL.</p></sec><sec><title>Выводы</title><p>Выводы. Отдаленные онкологические результаты в целом сопоставимы, однако частота рецидивов несколько выше у пациентов после криоабляции. Частота рецидивов РПЖ была статистически значимо выше у пациентов группы ISUP 3. У пациентов группы ВИФУ-терапии показатели качества мочеиспускания были лучше, чем у пациентов других групп, что можно связать с предварительно выполненной им лазерной энуклеацией гиперплазии предстательной железы. Преимущество у пациентов после ВИФУ-терапии наблюдалось при сравнении по показателям МИЭФ-5, таким образом, ВИФУ-терапия оказала лучшее влияние на качество жизни пациентов с локализованным РПЖ. </p></sec></abstract><trans-abstract xml:lang="en"><p>The purpose of this work is to study the functional and oncological results of minimally invasive methods in patients with verified prostate cancer.</p><sec><title>Materials and methods</title><p>Materials and methods. In our study, 160 patients with identified prostate cancer were presented, treatment was carried out with minimally invasive methods (methods of cryoablation (n = 53), brachytherapy (n = 52) and HIFU therapy (n = 55)). A qualitative assessment of the oncological outcome revealed high levels of prostate-specific antigen (PSA) and the results of repeated transrectal prostate biopsies. The evaluation of functional indicators and quality of life was carried out according to the results of the IIEF-5 (International Index of Erectile Function), IPSS (International Prostate Symptom Score), QoL (Quality of Life), Qmax (maximum urination rate of function).</p></sec><sec><title>Results</title><p>Results. The results of oncological control according to the data of positive repeated biopsies were worse in patients after cryoablation (7.54 %), the best indicators of oncological results were observed in patients after brachytherapy. Looking at the IPSS results, it is possible to detect statistical signs of higher scores in the brachytherapy group when various signs are found in the postoperative period, however, these differences do not reach statistical signs in the late period in patients of group brachytherapy and cryoablation. Patients of the cryoablation group showed higher levels of the IIEF-5 in the postoperative period, in the late period of observation of erectile function in patients  of the cryoablation group, the statistical data did not differ from those in patients after brachytherapy. Patients after HIFU therapy showed a decrease in de novo erectile dysfunction over a 3-year follow-up period, above average IIEF5 scores, below IPSS scores, and better QoL results.</p></sec><sec><title>Conclusion</title><p>Conclusion. Long-term oncological results are, in general, revisions, however, the recurrence rate is slightly higher in patients after cryoablation. Prostate cancer recurrence was detected in patients of the ISUP 3 group. In patients after HIFU therapy, the quality of urination is higher than in patients of other groups, which can be associated with the laser enucleation of prostate hyperplasia performed by him. The advantage in patients after HIFU therapy was observed in the detection of IIEF-5, thus HIFU therapy had a better effect on the quality of life of patients with pathological prostate cancer.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>брахитерапия</kwd><kwd>криоабляция</kwd><kwd>высокоинтенсивная фокусированная ультразвуковая терапия</kwd><kwd>локализованный рак предстательной железы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>brachytherapy</kwd><kwd>cryoablation</kwd><kwd>high-intensity focused ultrasound therapy</kwd><kwd>prostate cancer detection</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Pettersson A., Robinson D., Garmo H. et al. Age at diagnosis and prostate cancer treatment and prognosis: a population-based cohort study. Ann Oncol 2018;29(2):377–85. 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