函館五稜郭病院におけるHigh risk前立腺癌の臨床的検討

Abstract

We assessed the outcomes of high-risk prostate cancer patients who received radical prostatectomy (RP), external beamradiation therapy (EBRT) or androgen deprivation therapy (ADT). Two hundred nineteen patients who were diagnosed with pathologically confirmed high-risk prostate cancer as defined by D’Amico between 2005 and 2011 were included in this study. Of them, 74 patients underwent RP. The 5-year cancer-specific survival (5yCSS) and 5-year PSA recurrence-free survival (5yPRFS) rates were 100 and 67.2%, respectively. A positive surgical margin and Gleason score≧8 were risk factors for PSA recurrence. The 5yPRFSs were 100, 74.4% and ‘unmeasurable’ for patients with 0, 1 and 2 risk factors, respectively. Ninety patients underwent EBRT. The 5yCSS and 5yPRFS rates were 95.2 and 74.2%, respectively. Fifty-five patients underwent ADT alone. Their 5yCSS and 5yPRFS rates were 93. 3 and 64. 3%, respectively. There was no significant difference in 5yCSS and 5yPRFS rates among the treatment groups. These results show that RP can be a treatment option for high-risk prostate cancer patients.