前立腺癌に対するStaging pelvic lymphadenectomyの検討

Abstract

1) Clinical stage C以下の23症例において, 60%の高率でリンパ節転移が認められた.原発巣のgradeとリンパ節転移率との関係では, 高度分化型0%, 中等度分化型33.3%, 低分化型75%であり, 部位的には閉鎖-内腸骨リンパ節への転移が最も高頻度(85.7%)であった.2) Conventional node dissectionを施行した14例ではlymphocele, lymphfistula, 外陰部・下肢の浮腫などの合併症が高頻度にみられた.3)Limited node dissectionを施行した9例では, 特に重大な合併症はみられなかった.4)術後合併症を少なくするために創ドレナージ法, 抗凝固療法など配慮が必要である

Between June, 1982 and May, 1985, 37 patients underwent pelvic lymphadenectomy for carcinoma of the prostate, 23 patients as an independent procedure. Of these 23 patients 7 had pelvic node metastasis. Node involvement occurred in 60% with clinical stage C tumors. Correlation with tumor grade revealed nodal metastasis in none of the latients with well differentiated tumors, 33.3% of those with moderately differentiated lesions, and 75% of those with poorly differentiated tumors. Metastatic disease most commonly involved the obturator-hypogastric lymphnodes (85.7%). Of the 23 patients, 14 underwent conventional node dissection, and 9 limited node dissection. Complications of lymphocele, lymphfistula, penoscrotal edema and lower extremity edema occurred mostly in patients with conventional node dissection. Limited staging pelvic node dissection provides information similar to that identified after more extensive dissection and can be accomplished with little morbidity.