前立腺全摘除術の治療成績

Abstract

1988年までの27年間に進行癌を含む63例の前立腺癌に対し全摘除術をおこなった.術前治療, 去勢術あるいは所属リンパ節郭清術の併用有無別に再発, 癌死, 生存成績について検討した結果, 補助療法を加えた全摘除術は臨床的早期癌や進行癌に対して優れた成績を示した.症例に応じた適切な補助療法の選択が今後の課題であると考える

Radical surgery was administered to 63 patients with prostatic carcinoma, of whom 48 were put under total prostatectomy, 13 under cystoprostatectomy and 2 under pelvic exenteration. Adjuvant therapy was given in three forms: pretreatment to 31 patients, castration to 44 patients and pelvic lymphadenectomy to 39 patients. The 7 patients in stage A survived without carcinoma. Of the 25 patients in stage B, recurrence was seen in 7 patients but there were no deaths and the 5- and 10-year cumulative survival rates were both 86%. Of the 24 stage C patients, 8 developed recurrence, 4 died with the disease, and the 5 and 10 year cumulative survival rates were 82% and 55% respectively. There were 7 stage D patients, of whom 3 developed recurrence and 2 died, and these patients had a 5 year cumulative survival rate of 86%. The results demonstrated that total prostatectomy with suitable adjuvant therapy is useful for advanced carcinoma as well as clinically early stage carcinoma.