前立腺癌骨盤内限局病期の予後

Abstract

1975年から1989年までに, 臨床病期A2-G 90例に病期診断骨盤リンパ節郭清を行い, 非再発率を検討した.1)リンパ節転移頻度は, 臨床病期および原発巣の組織学的分化度の低分化傾向と共に増大した.2) pN0-1に対し, 根治的治療法として, 前立腺全摘除術, または放射線療法を行い, 良好な成績をみた.したがって, 現時点では本病期は治癒的病期とみなした.3) pN2以上には内分泌療法を行い, 病期D2よりは良い傾向をみた.以上より, 病期D1においてはpN1は根治的治療法, pN2以上には内分泌療法の適応と考えた

Between 1975 and 1989, 90 patients with prostate cancer in clinical stage A2 to C underwent pelvic lymphadenectomy. Median follow-up period was 38 months. Almost all of the patients with pN0-1 (49) and 4 of pN2 were treated by curative treatment, such as radical prostatectomy (7) or radiation therapy (45). The remaining pN2 (26), pN3 (4) and pM1 LYM (6) received endocrine therapy. Pelvic lymph node metastasis were noticed in 50 cases (56%). Rates of positive node and degree of nodal extension were related to clinical stage and histological grade. Disease-free survival of the patients with pN0-1 was better than that of the patients with more than pN2. There was no difference in disease-free survival between the patients with pN0 and pN1. We concluded that the patients with pN0 and pN1 were the candidates for curative therapy and recommend that the patients with more than pN2 be treated with endocrine therapy.