前立腺癌152例の臨床的および病理組織学的検討

Abstract

前立腺癌152例の統計分析を行った.前立腺癌(主としてホルモン療法を行った)の予後の判定には, 通常の規約分類(structural atypism-SAT)に, 細胞異型度(nuclear anaplasia-NAN)を加味したgrade分類が有用である.G3の予後は, 有意に悪い.再燃も, gradeによってきれいに分けられ, G3では, 再燃率が高く, また, 再燃までの期間も有意に短い.前立腺癌の予後の向上をはかるには, G3の主たる構成要素であるmedullary, column-cord typeの癌細胞に対し, 有効な化学療法を考えなければならない.他方, ホルモン療法も必ずしも良い方法とはいえず, 再検討の必要がある

A total of 152 prostatic cancer patients who underwent mainly hormone therapy was conducted. Our histological grading system combined with structure atypsim--SAT and nuclear anaplasia--NAN allowed for more accurate prognosis of prostatic cancer patients. The prognosis of G3 patients was obviously poor. The over-all 5-year survival rate for prostatic cancer patients with G1, G2 and G3 was 80%, 57% and 17%, respectively. The 5-year reactivation rate for patients with G1, G2 and G3 was 14%, 32% and 87%, respectively. The period for reactivation after initial hormone therapy for prostatic cancer patients with G1, G2 and G3 was 11.4, 10.0 and 3.2 years, respectively. Further improvements in survival for the patients with G3 prostatic cancer will require the development of effective systemic chemotherapy and the re-consideration of appropriate use of hormone therapy.