Noldus J, Graefen M, Haese A, Henke R P, Hammerer P, Huland H
Department of Urology, University Hospital, University of Hamburg, Germany.
Eur Urol. 2000 Jul;38(1):74-8. doi: 10.1159/000020255.
To determine whether migration of pathological tumor stages in patients with clinically localized prostate cancer exists and whether this is due to an increasing frequency of treating patients with clinically insignificant cancer.
1,063 radical retropubic prostatectomies were performed in patients with clinically localized prostate cancer in one institution within 7.5 years (from 1992 until June 1999). All specimens were prospectively processed according to the Stanford protocol. These were then analyzed regarding the migration of pathological tumor stages and cancer volumes.
Within the observation period, the annual rate of radical retropubic prostatectomies increased by 225% from 69 to 224 cases. The authors noted a decline of advanced tumor stages (from 65 to 40%) and an increase in pathological T2 tumors (from 30 to 55%). The rate of small cancers (<0.5 cm(3)) remained stable between 2 and 5% over the last 5 years.
The data confirm trends which were observed in large US centers with increasing detection and treatment of localized prostate cancer without unnecessary treatment of clinically insignificant cancers.
确定临床局限性前列腺癌患者中病理肿瘤分期是否存在迁移现象，以及这是否归因于对临床意义不大的癌症患者进行治疗的频率增加。
在7.5年时间内（从1992年至1999年6月），一家机构对1063例临床局限性前列腺癌患者实施了耻骨后根治性前列腺切除术。所有标本均按照斯坦福方案进行前瞻性处理。然后对这些标本的病理肿瘤分期和癌体积的迁移情况进行分析。
在观察期内，耻骨后根治性前列腺切除术的年手术率从69例增至224例，增长了225%。作者注意到晚期肿瘤分期有所下降（从65%降至40%），病理T2期肿瘤有所增加（从30%增至55%）。在过去5年中，小癌症（<0.5 cm³）的比例在2%至5%之间保持稳定。
数据证实了在美国大型中心观察到的趋势，即对局限性前列腺癌的检测和治疗增加，且未对临床意义不大的癌症进行不必要的治疗。
