前立腺癌の臨床統計的観察

Abstract

1971年7月以降13年間の179症例について検討した.1)受診時年齢は70歳代が46.9%で最も多く, 平均年齢72.4歳であった.2)初診時の主訴としては, 尿路閉塞症状が76%を占めていたが, 遠隔転移部の症状を主訴としたものが8.9%に認められた.3)組織診断の手段としては, TURが81.6%, 針生検術14.0%の順であった.4) Stage分類では, stage A 64, stage B 21, stage C 38, stage D 56例であった.5)死亡症例66例の死因は, 癌死31, 他癌死10, 心筋梗塞8, 脳血管障害5, 肺炎6例であった.なお心血管障害8例中, 抗男性ホルモン剤を投与されていたものは6例であった.6)自験例全体の実測生存率は, 1年89%, 3年70%, 5年55%であり, stage別5年生存率は, stage A 72%, B 67%, C 55%, D 34%であった.7)抗男性ホルモン剤投与の有無による生存率を各stage別に比較検討したところ, stage B, C, D群において投与群の生存率が延長する傾向が認められた.9)抗男性ホルモン剤投与群において, 投与量別にその生存率を比較検討したところ, stage Aでは少量投与群, stage B, Dでは大量投与群の予後が良好である傾向が認められた

Between 1971 and 1984, 179 patients with prostatic cancer were admitted to our Hospital. These cases were studied retrospectively. The greatest number of patients were in their seventies. The patients ranged from 55 to 90 years old with an average age of 72.4 years. The most common symptoms were dysuria, urinary retention, pollakisuria and macrohematuria. About 76% of the chief complaints were related to urinary tract obstruction. There were 64 (35.8%), 21 (11.7%), 38 (21.2%) and 56 (31.3%) cases of stage A, B, C and D, respectively. Prostatic cancer was confirmed histopathologically at transurethral resection in 146 patients, transrectal needle biopsy in 25 patients, open prostatectomy in 3 patients, autopsy in 4 patients, and cryosurgery in 1 patient. The 1-, 3-, and 5-year actual survival rates of 162 cases were 89, 70 and 55%, respectively. The 5-year actual survival rate of stage A, B, C, and D was 72, 67, 55 and 34%, respectively. The 5-year actual survival rate for the cases treated with and without anti-androgen therapy was 72% and 73% for stage A, 66% and 75% for stage B, 58% and 44% for stage C and 37% and 12% for stage D, respectively. The cases treated with anti-androgen therapy was divided into the low dose (diethylstilbestrol less than 300 mg/day or hexestrol less than 30 mg/day) and high dose (diethylstilbestrol greater than or equal to 300 mg/day or hexestrol greater than or equal to 30 mg/day) groups.(ABSTRACT TRUNCATED AT 250 WORDS)