前立腺癌に対する前立腺全摘除術と放射線療法の治療成績の比較

Abstract

前立腺癌で骨盤内リンパ節廓清後, 前立腺全摘除術あるいは放射線療法を施行した55例を対象とした。リンパ節転移陰性例の10年実測生存率は, 全摘群で70%, 放射線群29%であった。疾患特異的10年生存率は, 全摘群で100%, 放射線群78%であった。リンパ節転移陰性例の5年非再発率は, 全摘群で97%, 放射線群で56%であった

Between 1982 and 1990, 55 patients with prostate cancer (clinical stage A2-C) underwent pelvic lymphadenectomy at the Public Toyooka Hospital. The patients were subsequently treated either by radical prostatectomy (36 cases) or external radiation therapy (19 cases). The age of the patients varied from 56 to 85 (Mean 73.1). The outcome of the 46 patients with negative lymph node (prostatectomy 31, radiation 15) were compared. The 10-year disease-specific survival rates were 100% for the patients treated by prostatectomy and 78% for those treated by radiation (P = 0.035). The 5-year progression-free survival rates for the prostatectomy group and radiation group were 97% and 56%, respectively (P = 0.013). Among the radiation groups, patients with well differentiated carcinoma showed a lower progression rate as compared to those with moderately or poorly differentiated carcinoma (5-year progression-free survival, 81 vs 20%, P = 0.094). The outcome of the 9 patients with positive lymph node (prostatectomy 5, radiation 4) was not satisfactory because of the high progression rates in the two groups (5 year progression-free survival, 30% in prostatectomy and 25% in radiation group).