前立腺癌内分泌療法の臨床的検討(第4報) 内分泌療法の初期効果と予後

Abstract

治療開始6ヵ月間(初期治療)を, 内分泌療法を主体に治療した未治療前立腺癌497例を対象とした.このうち, 初期治療が内分泌療法のみであった内分泌療法単独群は443例である.1)前立腺局所反応の程度とstageとの間には明らかな相関はなかった.各stageにおける前立腺局所反応の程度と予後とは良く相関した.すなわち, 前立腺局所が治療後"平坦化"あるいは"縮小"した群の生存率, 生存期間は"不応"群より明らかに良好であり, この変化が予後を予測する上で有用と考えられた.2)病理組織学的所見のうちSATのgradeは, 前立腺局所反応の程度とは明らかに相関していた

We have already pointed out by the use of multivariate analysis that local response of the prostate is one of the important prognostic factors in patients receiving endocrine therapy. Herein, we investigated how the local response to endocrine therapy affects the survival rate or the survival period. We also studied the relationship between the local response and histopathological findings. The local response of prostate was not correlated with the stage progression. Sixty-seven percent of the patents in each stage had an initially favorable local response of the prostate, in which the primary tumor became flattened or reduced by endocrine therapy. By contrast, the local response of the prostate was well correlated with the prognosis in each stage. Patients with a flattened or reduced primary lesion following endocrine therapy showed a higher survival rate or a longer survival period than those with the unchanged lesion. This result has confirmed that the local response of prostate to endocrine therapy is useful in predicting clinical courses of patients. Grade of structural atypism (SAT), one of the pathological findings, had a correlation with local response of the prostate. With an elevation of the SAT grade, the proportion of patients with unchanged primary lesion was increased.