前立腺癌における長期生存例の分析

Abstract

初診より3年以上経過し, 1984年10月時に生存中の15例の前立腺癌を対象として検討を加えた.初診時年齢は56歳から84歳, 生存期間は3年から8年であった.初診時のstageと生存期間の間には統計的有意差を認めなかった.stageとgradeについてはstage Dでgrade 1から3まで幅広く存在した.一般状態については, 全例初診時grade 0または1であり, 3年以上経過後死亡1例, 不変6例, 悪化9例, 改善なしであった.stageの変動をみると, 改善1例, 不変12例, 進行2例で, 進行した2例は初診時のstage AからDへ移行しした.治療法では根治的前立腺全摘除術を1例に行ない, 今後は手術適応を広げたいと考えた.エストロジェン療法が主体であったが, 長期投与による副作用が問題となった.浸潤増殖型の前立腺癌が増加傾向にあり, 手術可能例には積極的手術を, 手術不能例に対しては制癌状態を長く維持する工夫が重要と考えられた

A clinical investigation was conducted on 15 prostatic carcinoma patients who survived for more than 3 years (as of October, 1984) since the initial examination. The patient's age at first examination ranged from 56 to 84 years, and survival time was from 3 to 8 years. There was no correlation between age at first examination and survival time. No statistically significant relationship was found between the initial examination stage and survival time. However, the Stage D group showed a wide-ranging survival time from the shortest to the longest survival time. In the relationship between stage and grade, as cited above, group D reflected multiple aspects of prostatic carcinoma in the broad spectrum observed from Grade 1 to Grade 3. The performance status of the 15 prostatic carcinoma patients was either Grade 0 or 1 at the initial examination. The group classified in Grade 0 at the time of the first examination displayed a more favorable performance status than the Grade 1 group now (P less than 0.05). Regarding the stage variation, 1 patient showed improvement, 12 showed none, and 2 reflected advance of the disease. It is important that radical surgery be indicated in any operable case, and in the inoperable cases long-term control therapy is required.