前立腺癌 - この10年間の臨床的研究 -

Abstract

1984年12月までの10年間51例について, 初診時排尿障害27例, 頻尿, 残尿感9例, stage Dが23例, Cが20例, 低分子癌では26/27例がC以上, 中分化癌では12/15例が, 高分子癌では5/9例がC以上の進行癌であった.43例が進行癌で, 低中分化症例が42例を占めた.D群の5年生存は31例とやや良好であった.癌死以外の死因第一位は心血管系で7例に認められた.初診より再燃までCで平均40±18ヵ月, Dで20±7ヵ月で, 再燃より死亡まではBでは33±7ヵ月, Cで22±12ヵ月, Dで4±2ヵ月となった.初診時の分化度に比し, 死亡時に低下するのはホルモン療法に不反応性の未分化細胞が増したものと推定される

Fifty one cases of prostate cancer were treated at Yamaguchi University Hospital during 10 years since 1975. Age distribution was between 43 and 90 years old with an average of 70.9 years. Chief complaints were difficulty on micturition (33%), complete urinary retention (19.6%), macroscopic hematuria (15.7%), and frequency (13.7%). Clinical stage was classified as 1 case (2%) with stage A, 7 cases (13.7%) with stage B, 20 cases (39.2%) with stage C and 23 cases (45.1%) with stage D cancer. Histological grade was classified as 9 cases (17.6%) with well differentiated type of adenocarcinoma, 15 cases (29.4%) with moderately differentiated type and 27 cases (52.9%) with poorly differentiated type. The 5-year actual survival rate was 75% for stage A&B, 50% for stage C and 60% for stage D. The 10-year actual survival rate was 20% for stage A&B, 17% for stage C and 20.5% for stage D. There were no statistically significant differences between stage, grade and survival rate. According to specific cause 18 cases (58%) were cancer deaths including 8 cases (15.7%) of refractory disease, and 4 cases (12.9%) of cardiovascular complication. Five of the eight refractory cases could survive over one year by multimodal treatment. Local irradiation to prostate was most effective to control symptoms against locally refractory prostate cancer.