限局性前立腺癌に対する前立腺全摘除術の検討

Abstract

前立腺全摘除術を施行した81例について 1)臨床病期のunderstagingは41%であり, T2とされた57例中28例がpT3であった. 2)所属リンパ節転移はpT2で3.3%, pT3で37%に認められた. 3)術後の再発率はpT3, 中分化～低分化型, INFγで高い. 4)術後に再発をきたした7例中, 全例が低又は中分化癌で6例がpT3, 3例がリンパ節転移陽性であった. 5)術後の排尿状態は55例では特別な問題はないが, 23例で軽度～中等度の尿失禁を認めている. 6)術後の勃起能は, 評価可能の18例中4例で維持されていた

We studied 81 patients who underwent radical prostatectomy for prostate cancer. Ten, 57 and 14 patients were clinically diagnosed with stage T1, T2 and T3, respectively. Pelvic lymph node dissection was performed prior to prostatectomy in all cases. The neurovascular bundle was preserved in 21 patients. Compared with pathological stage, the accuracy rate of clinical staging in T1, T2 and T3 was 40, 46 and 64% respectively. Approximately half of the patients clinically diagnosed with stage T2 were pT3. The positive rate of lymph node in pT2 and pT3 was 3.3 and 37% respectively, showing a marked difference between these two pathological stages. The 3-year non-recurrence rates were 89% in patients with pT2 and 79% in pT3. In the well differentiated carcinoma group, no patients had recurrence for up to 3 years. All of the patients with infiltration (INF) gamma showed recurrence within 3 years. Fifty-five patients had no problem on urination post-operatively, while the other 23 patients had a mild or moderate incontinence and the remaining 3 patients had a small urine stream. Regarding erectile potency, 4 out of 18 evaluable patients were potent.